LOKMANYA MEDICAL FOUNDATION’S

COMPANY HEALTH SERVICES

Lokmanya Hospital Nigdi Pune 44.
OCCUPATIONAL HEALTH

Dr. V.P. Joshi

Director
Company Health Services
 DEFINITIONS
 Occupational health: It is promotion
and maintenance of highest degree of
physical, mental and social well being in
all workers in all occupations

Occupational Disease: This is a disease

arising out of or during the course of an
employment
 History of Occupational
Health
 Dr. Ramazzini From Italy is known
has the father of occupational Health
 Way back in 1700 , He wrote the first
Book on Occupational Health
 He started the concept of asking of a
question to each and every patient
“ What is your occupation ?”
History of Occupational
Health
 18th Century Industrial Revolution in European
countries set the pace of Indstrialization all
over the world. However, in turn it created
problems of Health amongst the workers,
which necessitates the study of occupational
health hazards and diseases
 History of Occupational
Health

 Awareness about Occupational Health started in

India in 19th Century
 The first Law about occupational Health came in
1881.
 Later on Various amendments followed
AIMS OF OCCUPATIONAL
HEALTH
 Provide safe occupational environment
 Increase and improve health, safety
and welfare of the workers
 Increase productivity and thereby
production.
 OCCUPATIONAL ENVIRONMENTS

 Man & mechanical agents (machines)

 Man & Physical, chemical and
biological agents
 Man & psychological agents (human
interactions)
 MECHANICAL AGENTS

 Machines
 Equipments, Instruments & Weights
 Moving and protruding parts
 Poor designs and installation of machines
and plants
 Injury
 PHYSICAL AGENTS
 Temperature: (i) Heat (ii) Cold
 Humidity
 Air movement
 Radiation (i) U.V.Radiation (ii) Ionizing radiation
 Light : (i) Visible (ii) Infra red (iii) U. V.
 Pressure : (i) Low (ii) High
 Noise
 Vibrations
 Electricity
 All the above factors affect the worker either
singly or in combination.
 CHEMICAL AGENTS

 Toxic Gases
 Dusts
 Metals and their compounds
 Chemicals Solvents
 BIOLOGICAL AGENTS
 Bacteria
 Rickettsia
 Parasites
 Fungi
 Viruses
 What is an accident????
 The physician : An unintentional injury
 The engineer : A technical failure
 The psychologist : A result of human errors & mistakes
 The sociologist : A result of conflicting interests
 The lawyer : An event that no one can be blamed for
 The statistician : A random occurrence
 The manager : An event that careless workers are to be
blamed for
 The average man : An act of God or Bad Luck
 Heat
 Stroke
 Cramps
 Exhaustion :
a. weakness
b. fatigue
c. headache
d. nausea
e. vomiting
 Permissible limit of Temp. Rise due to Heat = 10 C
 Permissible limit of sweating = 600 ml/hr
 Noise
 Harmful Noise due to :
a. Industry b. Machines c. Vehicles
d. Entertainment e. war
Man can hear sound from 20 Hz to 20,000 Hz. Frequency
 Speaking (talking) frequency is 250 to 2500 Hz.

 Noise Induced Hearing Loss (NIHL)

 Dip at 4000 hertz
 Intensity of sound = db
 Silent room – 40 db
 Shouting - 100 db
 Extremely loud (Rocket) – 180 db
 Safe limit of Noise hearing is 90 db for 8 hrs.
 PSYCHOLOGICAL AGENTS
 At work
(i) Human relation with inferiors,
equals, superiors
(ii) Work – type, rhythm, stability,
security job Satisfaction,
rewards, incentives and welfare
(iii) Home – economic environment
and social relationships etc.
 Social Agents
 Absenteeism
 Alcoholism
 Sickness
 Prevention of
Occupational Health
Hazards
 It can be done at Three Levels

 Source

 Air-Path

 Receiver
 Source
 Substitution

 Change of Process

 Enclosure

 Wet method

 Local Exhaust - Ventilation

 Air - Path
 House Keeping

 General Ventilation

 Increased Distance (Remote Control)

 Monitoring – Pre set Alarms

 Receiver
 Training and Education
 Rotation of Workers
 Personal Monitoring Device
 Personal Protective Device
 Positive Health
 Periodical Medical Check-up
 Industrial Hygiene

 It is the science and art of recognizing,

evaluating and controlling
Occupational Health Hazards.
 T. L .V . Threshold Limit Value
 For Toxic Air Borne contaminants
 Bio-Chemical Monitoring –
 Urine , Blood Level of toxic substances
 ERGONOMICS...
 The term “ergonomics” is
derived from two Greek words:
“ergon”, meaning work and
“nomoi”, meaning natural laws.
Ergonomists study human
capabilities in relationship to
work demands.
 INTRODUCTION
 As early as the 18th century, doctors
noticed that workers whose jobs required
them to maintain certain body positions
for long periods of time developed
musculoskeletal problems. In the last 20
years, research has clearly established the
connection between certain job tasks and
stress injuries ie. Backache
 RULES OF ERGONOMICS
 Straight Back Rule
 Pelvic Tilt Rule
 Belly Button Rule
 Swing Arm Rule
 Straight Wrist Rule
 Straight Eye Rule
 No Skin Touch Rule
 Think first rule
 No Brain Machine Rule
 Backache
 Back injuries are some of the most common
and costly injuries in the work place

 An estimated 80% of Indians will suffer a

back injury at some time in their life

 Low back pain most commonly occurs in

people aged 30 to 50 years old

 Back injuries cause loss of work and cost

billions per year.
Back Injuries are Caused by:
 Improper Lifting
 Faulty posture
 Overuse of certain
muscles and joints
 Stress and fatigue
 Poor general health,
lack of physical fitness,
loss of suppleness
 Trauma
Lower back in arched
position
 Keep the lower
back in its normal,
“arched” position
while lifting (With
back arched, forces
are more evenly
distributed on the
support structures)
 STANDING
 Perhaps you were taught to stand up straight,
chest out, shoulders back. The military stand is
not a natural one and can give rise to a weak
back. This posture allows the for ward curve in
the lower back to accentuate, leading to
swayback. Swayback places stress on the inter
vertebral disks, particularly in the lumbar area.
Stress in this area can cause herniation and
sciatic pain. Swayback is a significant problem
found in the way people stand.
 If you work standing, stand with one foot elevated to a
comfortable level and switch feet every half hour or
so.
 Do not stand bent forward at the waist with your work
in a low position.
 Move your work surface up to a comfortable work
level so you do not have to slouch.
 Do not stand for long periods of time wearing high-
heeled, hard-heeled, or platform shoes.
 It is important to ensure that the abdominal muscles
which play a vital role in the support of the lower
back and spine are kept in good tone.
TABLE HEIGHT
STANDING
How should you stand?
Do you stand up
straight?
Look at yourself in the mirror Raise your chest
up and pull in your abdominal muscles.  Don't
let your stomach slouch. Keep your hips and
pelvis tilted slightly forward. Allow a tiny curve
in your lower spine. This keeps excess pressure
from being placed on your lumbar vertebrae.
Distributing your weight uniformly along your
spinal column helps prevent weak areas from
being stressed.
 BENDING:
 Do not forget to move your whole body when you are
leaning forward.
 Bending at your knees and hips and not your back.
 Position yourself so that you have the best possible
leverage when lifting.
 REMEMBER: a 50 pound object lifted improperly with
the knees locked and the back bent forward will exert in
excess of 650 pounds of force on your low back!
 Use your arms and particularly the powerful muscles of
your legs to perform the work of lifting and not your back.
BENDIN
G
 Lifting

 When lifting, always bend the knees; do not

bend at the waist. Let your leg muscles do
the work, not your back muscles. Never
bend without using your legs.
 Think about what you are lifting, make sure
you have enough muscle power.
 Better to be a wimp than have a bad back.
Warm-up Exercises
 Prior to lifting, you
should warm up
your muscles with
a couple of
stretches – like
hamstring
stretch…
Test Weight of Load

 Prior to lifting or
moving an object,
test the weight of
the load to make
sure it can be
moved safely
Test Weight of Load
 Test the weight by
lifting a corner of
the object. If it is
too heavy or if the
object is an odd
shape, STOP!
Lifting
 Bring the load as
close to the body
as possible and no
more than waist
high. (The closer to
your spine, the less force it
exerts on your back.)
Lifting
 Bend at the knees
or hips, not at the
waist.
 Point your toes out.
Awkward Loads
 It is better to drop
a heavy or
awkward load
rather than risk an
injury by jerking or
moving incorrectly
 Keep the head and
shoulders up as the lifting
motion begins (This helps to
keep the arch in the lower back)
 Tighten the stomach
muscles as the lift begins
 Keep your weight centered
over your feet.
 Lift with the legs and stand
up slowly, moving in a
smooth, even motion
Lifting and Carrying
 Check the path of travel or
destination of the load to
make sure it is clear
 Clear the path before
picking up the load
 One of the most frequent
causes of back injuries is
falling while carrying a
load
Lifting and Carrying
 Break a large load into
several smaller ones,
whenever possible
 Take small steps
 Move the feet (pivot) if
a direction change is
necessary. (This
eliminates the need to
twist at the waist, thus
reducing the stress on the
supporting structures of
the back)
Lifting and Carrying
 Use a wide, balanced
stance with one foot
ahead of the other
 A solid base of
support reduces the
likelihood of slipping
and jerking
movements
Carrying
 Turn correctly -- slow
and easy. Lead with
foot pointing in direction
you want to go
 Never try to change
grips while carrying
heavy load. (If load is
slipping, set it down and get
a better grip)
Ask for Help
 If an item is too
heavy or awkward
to carry, request
assistance from a
co-worker
Lowering Load
 Put down as carefully as you
picked it up -- squat straight
down using only leg muscles
 Lower load slowly, bending
at the knees
 Make sure fingers don’t get
caught under the load
 Make sure fingers don’t get
caught under the load
Steps to Prevent Back
Injuries
 Avoid twisting
motion as you
move objects
Steps to Prevent Back
Injuries
 When stacking
items, keep stack
below shoulders
and above the
knees
Steps to Prevent Back
Injuries:
 Do not reach for things
above your head or out
of reach
 Heavy items should be
kept between 30-50”
from floor to eliminate
need for reaching
Push -- Don’t Pull
 Push instead of
pull heavy objects
whenever
possible

(This puts less strain

on the back)
TIPS TO IMPROVE YOUR DESKTOP
WORKSTATION
 Ensure that chairs and work surfaces are adjusted
properly and that there is enough space to work in a
comfortable position
 Eliminate glare by properly positioning lights and desk
 Eliminate shadows by using task lamps
 Adjust window curtains and blinds as conditions vary
though the day
 Vary task to change body position
 Place frequently used items within easy reach
 Work stations should be designed to avoid unnatural
postures. Operators should not have to lean forward and
backward unnecessarily. The use of a device to incline
the work piece freely in any direction can often help in
complicated assembly jobs. Rotary platforms may also be
utilized to access the far side of a work piece and thereby
eliminate bending and extended reaching.
WORK STATION
 Footrests should be provided where chair or work station height
adjustments cannot be made sufficiently to allow the relief of pressure
under the thigh from the seat. These should be angled and covered
with a non-slip surface to provide comfortable support for the feet
 Headrests should be considered for operators where the head must
be tilted forward or backward for prolonged periods. A common
application is the use of optical viewing tools such as microscopes.
The head is relatively heavy. If the head is not kept straight, the pull
of gravity will cause stress and strain in the muscles of the neck
 Hand rests should be provided for intricate tasks such as fine
assembly or inspection. With the weight of the arm supported, the
hand is stabilized improving hand dexterity and comfort.
 Armrests should be provided when tasks require the arm to be held
away from the body. The further the arm is held away from the body,
the greater the fatigue and subsequent decrease in manual control.
Armrests should be padded and covered with an absorbent non-slip
material.
WORK STATION
Awkward positions of
Driving
Awkward positions of
Driving
Awkward positions of
Driving
Awkward positions of
Driving
Awkward positions of
Driving
Awkward positions of
Driving
Correct Position of Driving
Psychological Illness
due to
Occupation
 Stress External Force
 Strain Resistance
Stress ↑ Strain ↓ = Illness
 Effects:
 Emotional
 Thinking
 Behavioural
 Physical
 Stress Management
 D Diet
 A Activity
 R Relaxation (Deep Muscle
Relaxation)
 E Empathy
 S Spirituality (Meditation)
 Because

LIFE IS PARAMOUNT TO US

we understand life
better, not just the
treatment.
 GET SET TO PRACTIC
ERGONOMICS FOR GOOD
BACKS….
NAMASHKAR