LECTURE

PRINCIPLES OF OCCUPATIONAL
HEALTH

Occupational Health
Promotion and maintenance of the highest
degree of physical, mental and social wellbeing of workers in all occupations
(WHO, 1983)

cont..
Occupational health is the multidisciplinary
approach to the recognition, diagnosis,
treatment, and prevention and control of
work- related diseases, injuries and other
conditions

Occupational disease
Occupational disease is any disease caused in

whole or in part by exposure in the work

environment, usually excluding workplace
trauma

Definitions
PREVENTION :
Reducing the incidence of disease or

condition
Reducing the prevalence of disease or

condition

cont..

CONTROL :

Ongoing programs aimed at reducing the

incidence and /or prevalence of disease or
condition
(Dictionary of epidemiology)

General principles of occupational

health
1. Avoidance of hazards (primary prevention)
2. Suppression of hazard at source
3. Optimization of working conditions

cont..
4. Governments responsibility, authority and
competence in the development and control
of working conditions

cont..

5. Primary responsibility of the employer for

health and safety at work place
6. Cooperation and collaboration on an equal
basis by employers and workers

cont..

7. Right to participate in decisions concerning

ones own work
8. Safe technology

cont..
9. Right to know and principle of
transparency
10. Continuous follow-up and development of
occupational health and safety

Where do we stand
Medical Care /Rehab :

Inadequate

Workers : Powerless. illiterate, children,

Bonded labor
Machines/Chemicals: Unsafe, Banned

cont..
Workplaces : Hazardous, No safety measures

Industrial Growth: Rapid and unplanned,

unregulated

Goals of occupational health

services
Protect from health and safety hazards
Protect local environment
Proper work placement
Adequate medical care
Maintenance of health

Avoidance of Hazard
PRIMARY PREVENTION :
1. Hazard surveillance
2. Hazard identification
3. Exposure assessment

4. Exposure prevention :
A) Source reduction :
a ) Material changes
* substitution
b ) Process changes
* physical condition
* machinery
* operations
5. Work organization
cont..

SECONDARY PREVENTION
A. Control of generated exposures:

1. Engineering controls :

enclosures
local exhaust
wet methods
general ventilation's

cont..
3. Administrative control
4. Personal protective equipments
B. Early therapeutic intervention

Rights of workers
RIGHT TO KNOW your employer must inform
you of any known hazards in your workplace,
and provide training so you can work safely.
RIGHT TO PARTICIPATE to participate in
health and safety issues in your workplace.
RIGHT TO REFUSE TO UNSAFE WORK the
right to refuse work that you believe is
dangerous to your health or safety, or the
health or safety of another worker.

WORKPLACE HAZARDS
CHEMICAL HAZARDS
PHYSICAL HAZARDS
BIOLOGICAL HAZARDS
ERGONOMIC HAZARDS

CHEMICAL HAZARDS
Every worker has the right to know about

hazardous chemicals in the workplace. It is

the duty of every employer to inform the
workers about the substances which they may
come into contact.

Cont
..
Hazardous chemicals can enter the body in
several ways:
can be breathed in (inhalation).
can be swallowed (ingestion) .
can be absorbed through the skin

(absorption).
Once in the skin, they may enter the
circulatory system and damage the body.

BIOLOGICAL HAZARDS
those who work with animals or plants, or in

health or child care.

living substances that can cause illness

or disease. They include bacteria, viruses

and fungi. Bacterial are found in the air,
water and soil and in living or dead
animals or plants.

Cont..
Viruses, bacteria and fungi can be passed
from one person to another, either directly
through contact with body fluids, or
indirectly through breathing.
Workplaces where biological hazards are

present are legally required to have written

safe work procedures and training to
ensure that all workers know how to
protect themselves.

Physical hazards
like equipment, machinery, electricity, noise,
heat and cold.

Machinery can range from heavy machinery, like

a press or a stamping machine, to smaller

equipment such as meat slicers or paper cutters.

Serious, immediate injuries such as the loss of

an arm or finger can result from working with

machinery.

Cont..
Excessive noise levels or prolonged noise

can damage the nerves in the ear causing

temporary or even permanent hearing
loss.

Ergonomic hazards
Adapting the workplace to the worker,

instead of trying to adapt the worker to the

workplace.
If work station, tools and equipment,

physical environment including lighting,

temperature and noise are not properly
designed.
undue stresses and strains can be placed

on the musculoskeletal system.

Cont..
Injuries that cause disorders of the
muscles, bones, blood vessels, tendons,
nerves and other soft tissues in the body
may develop in workers who:
Maintain fixed positions.
Perform repetitive movement of the limbs.
Work with great speed along with
repetitions.

High Risk Workers

Workers in small businesses

Young workers
Women
Old

Safe Technology
Accident :
unanticipated, sudden event that may cause
an undesired outcome
Like- property damage, bodily injury,

death
Nature of accidents
Classification of accidents

Safe technology cont..

Injury :

Physical damage to body tissues caused by

an accident or by exposure to environmental
stresses

Elements of safety
program
Multidisciplinary effort involving interaction
among many groups within organization
Most of safety policies include :
Commitment to provide the greatest possible

safety to all employees

Safety program
cont..
All occupational injuries and accidents be
reported, investigated and corrective actions
taken
Clear explanation to all employees of their

exposure

Safety program
cont..
Establishment of training programs to
minimize their risk
Disciplinary procedures for employees and

supervisors who engage in unsafe behavior

Key players in safety

execution
First line supervisors
Safety directors
Physicians
Nurses
Maintenance department
Workers

Limitation of medical
science
Difficulty of differential diagnosis
Lack of epidemiological and toxicological

studies
Multiple causal pathways
Limitation of physician training

OPTIMIZATION OF WORKING
CONDITIONS
Education and advice :
- develop an educational program in the
trainees literal & technical language
- define specific and clearly stated goals
for each session

Education and advice

cont..
- Build an evaluation mechanism that can
easily be adapted to each program
- use participatory teaching methods

Participatory teaching
methods
Speakouts (large group discussions)
Brain storming sessions
Buzz groups (small group discussion or

exercises)
Hands-on-training
Report-back sessions

Personal protective
equipment
Respirators
Earplugs
Gloves
Protective clothing

Organization measures
Taken by employers
Implementing work schedules
Good environmental monitoring data
Pre-placement examination

Screening & surveillance

Secondary prevention
Identification of health events
Documentation of early evidence of adverse

health effect occurred

Early identification of inadequate control
measures

INITIATING PREVENTIVE
ACTION
Health professionals after identifying work-

related disease or injury can follow-up as:

1. Advice the patient :
- nature and progression of condition
- appropriate engineering control to
remove hazard
- the necessity to change job

Contact research or expert

group

NIOSH.
State department of labor and public health
Medical School or school of public health
Groups with expertise, experience and
interest

Conclusion
Our key of principles should be :
Identifying the magnitude of problem
Knowing scientific knowledge of the source
Correlating the technical knowledge and

practical skills for the prevention and control

PRINCIPLES OF OCCUPATIONAL
HEALTH
References:
(i)Dr .Syed Irfan Karim, Aga Khan University, Karachi.
(ii)Basic Environmental Health. Yassi, A., Kjelllstrm, T., de Kok,
T. and Guidotti, T. L., 1st Ed. Oxford University Press New
York, USA. 2001.
(iii)Environmental Science (The Way the World Works). Nebel,
B. J. and Wright, R. T., 1st Ed. Prentice Hall International Inc.
London, UK. 1998.