OCCUPATIONAL HEALTH HAZARDS PREVENTION & FIRST AID

OCCUPATIONA HEALTH IS ESSENTIALLY A PREVENTIVE MEDICINE

It is a science of the anticipation, recognition, evaluation and control of hazards arising in or from the work place which could impaired the well being of the workers also taking into account the possible impact on the surrounding community and the general environment

At the first session of joint committee of ILO and WHO held in 1950, occupation health was defined as Occupational health should aim at the promotion and
maintenance of the highest degree of physical, mental and social well -being of workers in all occupation

A hazards is a potentially unwanted event

TYPES OF OCCUPATIONAL HAZARDS

Physical hazards Chemical hazards Biological hazards Mechanical / Electrical hazards Psychosocial hazards

HEAT

[[[[[[

PHYSICAL HAZARDS
Heat exhaustion heat stroke Burns Heat cramp.

The direct effects of heat exposure are

COLD
Important hazards associated with cold work Frost bite Chilblains Immersion foot General hypothermia as a result of cutaneous vasoconstriction

LIGHT
Effect of poor illuminations are : Headache Eye pain Lachrymation Congestion around the cornea Eye strain Eye fatigue Exposure to excessive brightness is associated with discomfort, visual fatigue, blurring of vision and may lead to accidents.

VIBRATION
Vibration especially in the frequency of 10 to 500 HZ, can affect hand and arm after month of years of exposure Ill effects are The fine blood vessel of finger becomes increasingly fingers). Injuries of the joints, of the hands elbow and shoulders may take place sensitive to spasm (white

RADITION
A.

Ultraviolet Radiation hazard- Seen in work with arc welding Ionizing radiation hazards
Aneamia Leukemia Cancer Sterility Foetal Malformation in care of pregnancy Ulceration In extreme cases death can take place

and mainly affects the eyes. Exposure to such radiation may lead to conjunctivitis and keratitis (Welder s flash)

B.

NOISE Industrial noise can give rise to deafness Non auditory effects are irritation, nervousness,
annoyance, fatigue, inefficiency

CHEMICAL HAZARDS
LOCAL ACTION
eczema dermatitis Cancer

INHALATION
1. Organic dust
Size ranging from 0.1 to 150 microns. Particle smaller than micron is called respirable dust and is directly inhaled into the lung and mainly responsible for pneumoconiosis different form depending upon the type of dust like Silika- silicosis, Asbestos-asbestosis- Irorn- sidrosis
Silica- Silicosis, Asbestors- Asbestosis, Iron Siderosis

in the

Inorganic dust
Cane fiber - Bagassosis Cotton - Byssinosis Tobacco - Tobacossis Incidents of pneumoconiosis depends upon the following factors Size of dust particle Chemical composition Duration of exposure- incubation period may range from few months to 6 yr Individual susceptibility

Sign and Symptoms

Irrigative cough Dysnaea (difficulty in breathing) Pain in the chest

2. Gases - Gases are the common hazards in many industries leads to suffocation and asphyxia. Asphyxiating gases are Carbon Monoxide, Cyanide, Sulphur dioxide, Chlorine etc. 3.Metals and compounds Toxic hazards are seen from Lead, Mercury, Chromium, Arsenic etc. 4.Chemicals Acid, Alkali and Pesticides.

MECHANICAL / ELECTRICAL HAZARDS

Accident Fall Injury Electricity burn Electric shock.

ACCIDENT

ACCIDENT
What is an accident?
An unexpected and undesirable event, especially one resulting in damage or harm to the man kind /properties. An unforeseen, unanticipated or unpredictable incident that may interfere with normal functions or cause logical or physical damage An accident at work is defined as an external, sudden and violent event, during the execution of work or arising out of it, which causes damage to the Health/ Property or loss of the life

CONTRIBUTING FACTORS
A. Human factor
Physical capability Sex- Women are known to have less accident than man Age- Younger age known to involve more in accident than older age group Time- Numbers of Accidents are minimum at the beginning of the day Experience- First 6 month- 50% accidents Next 6 month- 23% accidents Next 6 month - 3% accidents Working hour - Long working hour associated with more accident Psychological ignorance, fatigue, stress, carelessness Temperature, humidity, noise, poor illumination, unsafe machine, poorly maintained machine

B. Environmental factor

BIOLOGICAL HAZARDS
Exposure to infective and parasitic agents Inset bite Dog bite Snake bite

FACTORS

PSYCHOSOCIAL HAZARDS

Maladjustment with work environment. Lack of job satisfaction Insecurity Emotional tension Poor human relationships Anxiety/Depression Sickness absentees

Behaviors changes

Health problems
Fatigue Headache Hypertension Heart disease Peptic ulcer

PREVENTION
Physical hazards
Application of ergonomics Maintenance of temperature- temperature of 69 to 80 deg. F is the comfortable zone Proper ventilation Good housekeeping Proper illumination Personal protection Personal hygiene Health education Job rotation Periodic health Check up

PREVENTION OF PEUMOCONIOSIS
1.Dust control Proper Ventilation Exhaust Enclosed apparatus Good house keeping

2.Personnel protection
Mask, clothing, cloves, apron, boots barrier cream etc

3.Personal hygiene 4. Health education about respiratory evolvement and personal protection 5.Medical control Periodic medical check up for early detection 6. Bagasse control Spraying with 2% propionic acid Keep the moisture content around 20%

MECHANICAL HAZARD
PREVENTION
Preventive maintenance Adequate job training Ensuring safe working environments Establishment of safety department with qualified safety engineer Periodic survey for finding out hazards Application of ergonomics

BIOLOGICAL HAZARDS
PREVENTION
Personal Protection Post Control

PSYCHOSOCIAL HAZARDS
PREVENTION
Good induction program. Management by participation. Establishment of Proper communication channel. Establishment of Healthy personnel policies Establishment of healthy HR relationship. Regular stress management program.

STRESS
WHAT IS STRESS ?

Stress is produced when the human body or mind is acted upon by forces that disrupt its equilibrium and produces strain. When our system is unable to handle this it produces pathological changes and disease

STRESS MANAGEMENT TIPS

Ways

to tune out, calm down and revitalization.

Zero In On Stresses Summarizing whats Wrong in two or three word Keep a Diary Time Your Troubles Drive Yourself to Diversion Dont pressurize yourself Establish Your Priority Set Mini Goals
Contd..

STRESS MANAGEMENT TIPS.cont

Learn to say polite No Live within Your Means Look on the Bright Side Feed Your Body Right Less Fat and Avoid Alcohol Stroll To De-Stress Squeezing for Release Keep The Beat Stretch for Relief Take a Break

FIRST AID

FIRST AID
First Aid is the initial assistance / care / treatment administered by a concerned person to a casualty for any injury or sudden illness, before the arrival of a doctor or before the evacuation of the victim to a safe place, that some times means the difference between life and death or between a full or partial recovery.

Aim of First Aid

To Preserve life To prevent the condition worsening To promote recovery

Principle adopted in First Aid

Immediate Action Clean composed and deliberate action

Scope of First Aid

Find out the Cause based on the following - History - Symptoms (what the casualty complains off) - Signs (what the first aider observes) Treatment Disposal

Golden Rules of First Aid

Remember the ABC of life A is for Airway B is for breathing C is for circulation Check and stop bleeding (hemorrhage) Prevention and treatment of shock. Immobilize the broken bones. Removal of the cause of injury / illness. Keep unconscious patient in recovery position. Nothing by mouth to unconscious and abdominal injury cases. Spinal injuries need careful handling and transfer on steel stretchers. No over doing. You are only a First Aider. Prompt transfer of the casualty to a safe place i.e. hospital / clinic

First Aid for wounds

Lie the casualty Clean your hands. Inspect the wound for any fracture and deal accordingly. Wash the wound with shop and water Stop bleeding if any Apply antisceptic cream or lotion and apply sterile dressing; Immobilize the limb in case of fracture

HOW TO STOP BLEEDING

(a)

By direct pressure :
Make the patient lie down Apply direct pressure over the wound or bleeding point with the thumb fingers or palm preferably over a sterile dressing or pad for about 5 minutes. If the bleeding does not stop after about 5 minutes then put an additional pad and bandage firmly. Raise the injured limb above the level of the patients heart. Secure and support the injured part.

(b)

By indirect pressure :

Indirect pressure may be applied above the bleeding point but not should not for more than 10 minutes. No such pressure for wounds of head, neck or torso.

BLEEDING FROM SCALP

Put sterile dressing and apply direct pressure.

BLEEDING FROM TONGUE, CHEEK

Clean the tongue and the cheeks (inside) and give ice cubes to suck. Do not give any warm things.

BLEEDING FROM NOSE

Mark the patient sit on a chair with head slightly bent forward in an airy place. Loosen the clothes of neck and chest. Advise the patient to breathe through mouth. Patient should not try to speak, swallow, cough. Spit or sniff as this may disturb the blood clot. Nose should be kept pinched with thumb, and forefinger. Cold compresses over nose and forehead may help. Do not remove clot from nose. No plugs are to be used. If bleeding persists for more than 30 minutes, the patient must be sent to a hospital.

SHOCK
Shock is a life-threatening condition that can be caused by severe bleeding, an injury or sudden illness. The circulatory system fails to carry oxygenrich blood to all body parts of the body It is basically a circulatory failure resulting in cessation or depression of vital functions of body.

Cont

Causes of shock
Bleeding Fractures Spinal injury Asphyxia Burns and scalds Sepsis Poisoning Snake bite Acute gastro enteritis (excessive diarrhea and vomiting) Contd..

Symptoms

Feeling of coldness. Sweating. May be difficulty in breathing. vomiting Thirst. Face and lips are pale. Cold and clammy (moist) skin. Restlessness, anxiety, confusion Rapid and weak (feeble) pulse. Dry tongue. Short rapid breathing. Unconsciousness in sever shock.
Contd..

Signs

First Aid Measures

If external bleeding try to stop it.

Lie him keeping the head low and foot end raised supporting his legs Loosen tight clothing of neck, chest and waist. Put blankets to keep him warm. Do not give him drinks or eats since he may need to be given anaesthesia later on for any operation. Lips can be moistened if he complains of thirst. In case of gastroenteritis, oral rehdration Do not let him move. Check pulse, breathing and level of consciousness. ABC, if required. Put him in recovery position if unconscious. Arrange for immediate transfer to a hospital.

ELECTRIC SHOCK
Immediately switch off the current. Or else with the help of wooden stick or a dry stick or a dry cloth move the casualty away with a jerk to break contact. Check breathing and pulse and carry out artificial respiration or CPR. Treat for the burns. Treat for shock.

SEVERE BURNS
Remove the burn source Cool the burned area with cold water (not ice) or wrap the victim in a cotton blanket or rug Cloth compression on burns of the hands, feet and face, but do not leave on longer than 15-20 minutes Check airway, breathing and pulse and resuscitation if required. Gently remove belts, rings, shoes Remove clothing but only if does not stick to burned area. If the arms and legs are burned elevate them above heart level Cover the burned area with clean cloth/ sterile dressing Treat shock, if present Immediate evacuation to hospital.

Burns with Acid And Alkali

Signs and symptoms
Severe burning of mouth and throat Difficult in swallowing and breathing Sever abdominal pain Thirst Shock Dark closured and blood vomiting

First aid
Immediately remove contaminated clothing.

Wash with sodabicarb solution(2 teaspoons baking powder in one pint of water) and in case of alkali burn wash with weak solution of vinegar. Again wash with water. Cover with sterile dressing Transfer to hospital.

ASPHYXIA
Asphyxia or suffocation is condition of partial or complete stoppage of breathing due to lack oxygenation in the blood. Brain cells start to die if oxygen supply is interrupted for just there minutes.

Important causes
Lack of Oxygen in the Air Obstruction of the Air Passage Failure of Respiratory Mechanism Depression of Respiratory Centre

Signs and symptoms

Rapid distressed breathing and gasping Blueness (cyanosis) of the skin, face lips, nails, ears and nose. Swollen neck veins Confusion, irritability and gradual loss of consciousness. If hypoxia continues and is not reversed, breathing and heart may stop.

First Aid measures

Immediate removal of cause or remove casualty from the cause. Artificial respiration or CPR if required Treat shock. Immediate transfer to a hospital If unconscious. Transfer in the recovery position.

Suffocation by smoke
Cover your mouth and nose with wet cloth or handkerchief before entering the room where the casualty is. Always crawl or keep low while entering the place. Open all the windows and doors. Remove the casualty to the open balcony or courtyard. Artificial respiration, if required.

FIRST AID FOR INHALATION OF CLORINE

Remove the casualty in fresh air. Immediately to an open area Clothes are to be loosened and shoes should be removed. Patient should be placed on his back with head and back elevated and kept warm. Milk, butter milk, lime juice, etc. may be given in mild cases, for relief from throat irritation Nothing by mouth to an unconscious patient.

If liquid chlorine or chlorinated water has contaminated skin or clothing give emergency shower.
Contd..

Skin areas should be washed with soap and water. No attempt should be made to neutralized chlorine with chemical. No ointments should be applied for 24 hours.

If eyes have been affected washed with running water for at least 15 minutes Give 2 or 3 drops of o.5% solution of pontocaine or other effective topical anesthetic in the affected eyes In case of Swallowing of liquid chlorine immediately give lime water, milk of magnesia or fresh water to drink.

No attempt should be made to induce vomiting a physician must be called in immediately.

Mouth to Mouth Respiration

Lie the casualty on his back (face up) on floor on table. Kneel on one side of the casualty. Remove any obvious obstruction in the mouth by passing a finger quickly inside. eg. foreign body, false teeth, vomited matter etc. Tilt the patients head well back (Head Tilt) with one hand and hold the chin up with the other hand (Chin Lift) this will open the airway lifting the tongue Pinch the nose with thumb and index fingers of the casualty with the hand which is on the head. Take a deep breath and place your moth over the casualtys mouth. Your lips should fully seal the casualtys mouth. Blow into the casualtys mouth gently until you see the chest rise indicating entry of air into the lungs. It takes about two seconds for full inflation. Remove your mouth and wait for the chest to sink back to its usual position. Take a deep breath and blow again. Repeat the procedure 10-15 times per minute.

Mouth to Mouth Respiration

CARDIO PULMONARY RESUSCITAION (CPR)

Before starting external cardiac compression, give a strong sharp thump (blow) on the lower part of sternum. Put the patient on hard surface on his back (face up). Knee down on one side of the patient. Locate lower tip of the patients breast bone (sternum) and place two fingers of your left hand on it. Move the heel of right hand (never the palm) against the 2 fingers . Place the heel of the left hand over the right and interlock the fingers. Press sternum directly with smooth firm thrusts and hold for half a second Then lift your weight relaxing pressure sharply and completely. Do not remove your hands from the chest Repeat this rhythmic compression press release press release 80 -100 times a minute (minimum is 60 per minute). Do not apply external cardiac compression if the patient is conscious. Do not apply too much pressure as it may cause ribs fracture. cont.

1. Call for Ambulance

How it works
It involves rhythmic application of pressure so as to compress the heart between the breast bone (sternum) and the spine, Compression expels the blood from the hearts chambers. On removal of compression, the chest rises and the blood is sucked in to refill the heart.
Cont

How to do CPR if alone i Artificial respiration 2 times and then external cardiac compression 15 to 2 rhythm. How to do CPR if 2 persons are there One person should do artificial respiration and the other person should do chest compression. Give one breath after every five chest compressions.

SNAKE BITE

SNAKE BITE
Signs and Symptoms
Presence of fang marks. Two or four means a poisonous snake bite ; continuous teeth mark of 8 or 4 means a non-poisonous snake bite. Dull, numbing pain and swelling at the bite site. May be slight bleeding at the sting site Painful cramps and muscle stiffness in the abdomen or shoulders, chest and back. Nausea, vomiting Giddiness. Restless, drowsiness ,breathless, convulsions fever, chills, sweating Foam from the mouth. Person may become unconscious. Contd..

First Aid
i Reassure the patient. i Immediate application of the broad bandage (preferably crape bandage) above the bitten area. i Immobilize the limb with splints. i Wash thoroughly the bitten area with water or soap and water. i Arrange quickest evacuation to a hospital.

Donts
i i i i Do not let the patient walk, run or shout. Do not excise or burn the wound of bite. Do not let the patient sleep. Do not apply tourniquet. Do not give alcohol.

DOG BITE
Thorough washing of the bitten part with soap and water. Even licks should be washed. If the wound is swollen, apply ice wrapped in a towel for ten minutes. Cover wounds with sterile dressings and send to hospital / clinic.

TICK BITES
i Remove any ticks found on the skin. Pull gently and carefully ticks mouth part not to crush the tick because the secretions released any spread disease. Wash the wound area with soap and water Apply clod compress to relieve pain and swelling Apply calamine lotion to relieve itching.

HEAD INJURIES
OPEN a head injury with an associated head wound. CLOSED with on obvious sing of injury CONCUSSION

is a closed head injury, of all the

head injuries, this is the most insidious, casualty.

Contd..

SIGNS AND SYMPTOMS

History of trauma

Head wounds Deformation and / or crepitus of the skull Altered level of consciousness Evidence of CSF leaking from ears or nose May have unequal pupils Headache Raccoon eyes or Battles sign ausea and / or vomiting estlessness and irritability, confusion lurred or double vision Snoring respirations if unconscious
Cont

CARE AND TREATMENT

ABC Call for an ambulance Treat any wounds Complete rest Head injury without any symptoms should be watch for at least 24 hr
If unconscious or drowsy, put casualty in the stable side

position while supporting the cervical spine llow any CSF to drain freely if in stable side position, put that side down with a pad over the ear

HEART ATTACK AND ANGINA

FACTORS
Lack of exercise Smoking Poor diet High blood pressure Hereditary Strain and stress High cholesterol
Cont

SIGNS AND SYMPTOMS

Pale, cool skin
Chest pain or discomfort, possibly after exertion, a heavy meal or stress crushing, or vice-like pain, usually in the centre of the chest, sometimes also in the jaw and arm sweating rapid, irregular, or weak pulse rapid, shallow respirations, or difficulty breathing nausea and/or vomiting may feel the need to pass a bowel motion lethargy
Contd..

CARE AND TREATMENT

ABC Call for an ambulance Position of comfort, usually sitting Complete rest Reassurance Assist with medication Discourage visit to the toilet/do not allow to walk.

HEART FAILURE
When the heart is unable to perform its proper function. SIGNS AND SYMPTOMS Pale, cold, clammy skin Chest discomfort, difficulty breathing Bubbly, gasping breaths Frothy sputum Swelling of the extremities, especially at the ankles, which may show dimples partial collapse Contd..

CARE AND TREATMENT

ABC

Call for an ambulance Position of comfort, usually sitting & supported Do not elevate legs Reassurance

CARDIAC ARREST
When the heart ceases to function.
SIGNS AND SYMPTOMS Unconsciousness No pulse Usually no respirations, though there may be brief irregular, gasping breaths

CARE AND TREATMENT

Immediate CPR Call for an ambulance
Contd..

Pesticide poisoning
If the pesticide has been spilled on the skin or clothing
Remove the clothing immediately if it has been contaminated and thoroughly wash the skin with soap and water. Rinse the affected area with water; wash again and rinse. Gently dry the affected area and wrap it in loose cloth or a blanket. Avoid ointments, greases, powders, and other medications unless instructed by a medical authority.
Contd..

If the pesticide has entered into the eyes.

Hold the eyelid open Immediately start washing the eye with clean running water for 15 minutes Do not use chemicals or drugs in the wash water Avoid contamination of the other eye if only one eye is involved. Cover the eye with a clean piece of cloth and seek medical attention immediately.

If the pesticide has been inhaled.

Get the victim to fresh air immediately. Do not allow the victim to walk. Have the victim lie down and loosen clothing. Keep the victim warm and quiet. If the victim is convulsing watch the breathing and protect the head. Keep the chin up to keep air passages free for breathing. If breathing stops or is irregular, give artificial respiration.

.If the pesticide has been swallowed. Most important decision to be made is whether or not to induce vomiting. Never induce vomiting if the victim is unconscious or convulsing. The victim could choke to death on the vomits. Never induce vomiting if the victim has swallowed petroleum products (kerosene, gasoline, oil, lighter fluid,). Never induce vomiting if the victim has swallowed a corrosive poison a strong acid or alkali (base). A corrosive poison will burn the throat. if you are certain the victim has swallowed a dilute preparation, have the person vomit immediately

How to induce vomiting

First give the patient at least two glasses of water. Do not use carbonated beverages. If possible use ipecac syrup to induce vomiting. After vomiting has occurred, give the patient 2 to 4 tablespoons of activated charcoal in water. Never administer activated charcoal at the same time as ipecac syrup,

TREATMENT OF FRACTURES
PRINCIPLES OF TREATMENT
Treat fractures on the spot. Immobilization of the fracture. (a) By bandages (Triangular or roller) (b) By splints For open fractures treat the bleeding and the wound Treat shock if present. Always be gentle in handling fractures

DONTS
Do not try to set broken bones. Do not let him walk unless injury is of upper arm. Do not try to push in a protruding bone. Do not evacuate spinal fracture cases on a canvas stretcher. Do not move casualty unless injured part is secured / supported. Arrange medical aid or evacuation.

FIRST AID FOR FRACTURE OF SPINE

Do not let the victim attempt to move. Greatest care be taken not to bend neck or back. Transfer the victim to a hard stretcher (not canvas stretcher). Fix the victim on the stretcher with the blankets round him. The victim should always be transported in supine (face upwards) position.

FIRST AID FOR FRACTURE OF RIBS

Apply two broad bandages round the chest firmly without removing the dress. Ask the patient to breathe out and then tie the knots below the arm pit on the uninjured side. Support the arm on the injured side with a sling. Lay the casualty with the head and the shoulders raised and the body inclined towards the injured side.

FIRST AID FOR FRACTURE OF CLAVICLE

Place the arm on the injured side across the chest. Support the arm in an elevated sling by a triangular bandage. Secure the arm to the chest with abroad bandage over the sling. Transfer in sitting position.

FIRST AID FOR FRACTURE OF THIGH BONE

Apply a long splint on the inner side of the affected limb from groin to heel. Apply an outer longer splint from armpit to heel. Apply Bandages at seven places to fix the two splints - At the chest - At the Hip Joint - Above the fracture - Below the fracture side - At the knees. - At the middle of legs At ankle (tie feet and ankles together with figure of 8 bandage) If nothing is available for splints. Use the second uninjured leg as splint.

FIRST AID FOR DISLOCATION

Do not try to reduced the dislocation
Apply split and bandage

FIRST AID FOR SPRAIN Rest the injured part.

Apply Ice or cold compress. Compress the injury (with thick layer of cotton wool secured by a bandage). Elevate the injured part.

Thank You