Occupational Health

in the
Construction Industry

Department of Labor and Employment

Occupational Safety and Health Center
 Session Objectives:
After this session, participants should be able to:

1. link and explain the common health hazards and

their health effects at the workplace especially in the
construction and shipbuilding industries

2. recommend appropriate measures to monitor the

health effects of the workers
 Aims of Occupational
Health (WHO/ILO)

 Promotion and maintenance of the highest degree of physical,

mental & social well-being of workers of all occupations

 Prevention among its workers of departures from health caused by

their working conditions

 Protection of workers in their employment from risks usually from

factors adverse to health

 Placing & maintenance of the worker in an occupational

environment adapted to his/her physiological ability.
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 Factors that Determine
Disease Development

Workplace factors
+
Workers’ susceptibility
________________________________
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 Health Hazards

Chemical Physical Biological Ergonomics

Welder Chromium Noise Mosquitoes Squatting
(Dengue, Malaria)
Nickel UV Radiation Repetitive
Tuberculosis Movement
Manganese
Tetanus Static posture
Lead
Grinder Silica Dusts Hand Vibration Mosquitoes Squatting
(Dengue, Malaria)
Metal Dusts Noise Forceful
Tuberculosis exertion
Tetanus
 Health Hazards
Chemical Physical Biological Ergonomics

Painter Paints Noise Mosquitoes Repetitive movement

Varnishes Awkward Posture
Thinner
Anti-fouling (pesticide)

Machine Operator Chromium Noise Mosquitoes Prolonged sitting

Nickel Whole Body
Manganese Vibration
Lead UV
Radiation

Pipe Layers Asbestos dusts Noise Awkward posture

Chemical Hazards
 Routes of Entry into the Body
Inhalation
(major route)

Ingestion

Skin Contact
 Organic Solvents
 Occupational Sources
– Paints
– Varnishes
– Adhesives
– Preservation agents

 Exposure
– Inhalation of vapors
– Skin absorption
Organic Solvents
 Organic Solvents:
Health Effects
 Neurotoxic Effects
– Affects reaction time, short-term memory
– Chronic toxic encephalopathy
• Tiredness
• Sleepiness
• Irritability

 Liver Effects
– Cirrhosis
– Cancer
 Organic Solvents:
Health Effects
 Respiratory Effects
– Bronchial Hyperactivity
– Pulmonary Edema

 Reproductive Effects
– Spontaneous abortion
– Malformations
– Infertility

 Kidney Effects
– Glomerulonephritis
 Organic Solvents:
Health Surveillance
 Complete Occupational History
 Complete Physical Exam
– Complete neurological test
 Laboratory Test
– Organic solvent metabolites
concentration in the urine
– Kidney profile
– Liver profile
 Lead
 Occupational Sources
- Lead smelters
- Welders
- Radiator repairmen
- Solderers
- Shipyard workers
- Garage workers
- Pipe fitters

 Exposure
- inhalation
- ingestion
Lead
 Lead: Health Effects

Symptoms: Fatigue, body malaise, difficulty in concentration,

headache

Diseases: Peripheral neuropathy

Hypertension
Anemia
Renal dysfunction
Teratogenic effects (Cerebral palsy, brain malformation)
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 Lead: Health Surveillance

 Complete Occupational History

 Complete Physical examination
 Diagnostic tests
– Blood lead levels
 Cement
 Fine, grayish green powder produced by heating cement
rock or other lime stone bearing materials

 Occupational Sources
- Construction
- Cement Manufacturing

 Exposure
– Inhalation
– Skin absorption
Cement
 Cement: Health Effects
Wet Powder Dry Powder
 Skin  Eyes
– Irritation – Irritation

 Eyes  Respiratory Tract

– Abrasion – Irritation
– Irritation – Small airway disease
– Pneumoconiosis
 Pneumoconiosis
 Accumulation of inorganic dusts in the lungs

 Chronic disease, typically with pulmonary fibrosis

 Often appear and progress long after exposure

 Silicosis, asbestosis, and coal dust are common forms that have
caused widespread morbidity and mortality.
Pneumoconiosis
 Pneumoconiosis:
Clinical Features
 Except for trouble breathing, patients with pneumoconiosis usually
have few or no physical signs

 Respiratory failure and/or heart failure eventually kill the patients

 Can cause Chronic Bronchitis, Emphysema, Bronchogenic Cancer

 Pneumoconiosis are incurable

 Inorganic Dusts:
Health Surveillance
 Complete Occupational History
 Complete Physical Exam
 Diagnostic Tests
– Chest X – ray
– Pulmonary function Test
Physical Hazards
 Physical Hazards

1. Noise
2. Vibration
3. Inappropriate Illumination
4. Extremes of Temperature
5. Radiation (Ionizing and Non-ionizing)
Physical Hazards
 Noise: Health Effects
 Temporary threshold shift
– Reversible

 Permanent threshold shift

– Irreversible

 Noise-induced hearing loss (NIHL)

– Irreversible
 Noise: Health Effects

1. Hearing Damage
2. Hypertension
3. Hyperacidity
4. Palpitations
5. Stress-related disorders
6. Interfere with work performance
7. Disturbs relaxation and sleep
 Noise: Health Surveillance

 Otoscopy  Audiometry
 Vibration

Types
1. Whole body
vibration
2. Segmental vibration
Vibration
 Vibration:
Occupational Exposures
 Pneumatic tool operators (chippers, staple gun & chain
sawyers operators, construction & road operation)
 Mining (jack leg & hand tool)
 Electrical grinder operators (rotary, stand, swing grinders)
 Metal extrusion operators
 Heavy equipment operators
 Vibration: Health Effects
1. Whole Body Vibration
– Fatigue
– Irritability
– Headache
– Cardiovascular disturbance
– Impotence
– Disorders of the spine
 Vibration: Health Effects
1. Segmental Vibration
– Hand - arm vibration syndrome (Reynaud’s Syndrome)
– tingling, numbness, blanching of fingers, pain
 Vibration: Health Surveillance
 Spinal X-ray (cervical, thoracic, lumbar, sacral)
 X-ray of the hands
 Nerve Conduction Velocity Test
 Inappropriate Illumination:
Health Effects

1. Visual Fatigue
2. Double Vision
3. Headaches
4. Painful irritation of eyes
5. Lacrimation
6. Conjunctivitis
Inappropriate Illumination: Health
Surveillance
 Complete Eye Examination
– Eye Chart (Snellen’s Chart)
– Ophthalmoscopy
 Heat Stress: Health Effects
DISORDERS MAIN CLINICAL FEATURES
Pruritic rash Itchiness, rash
Heat cramps Cramps in limbs
Heat exhaustion Dizziness, blurring of vision
with cold and clammy skin
Heat stroke Convulsions, muscle twitch,
delirium with hot and dry
skin; Temp > 41°C
Biological Hazards
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Biological Hazards
 Tuberculosis
 caused by the bacteria, Mycobacterium
tuberculosis

 caused by droplet nuclei released when sneezing

and coughing

 Symptoms: weight loss, low grade afternoon fever,

persistent cough, blood-streaked expectoration or
hemoptysis
 Tuberculosis

Diagnostic Tests
1. Sputum Exam ( 3 consecutive days )
2. Chest Xray
3. Bronchoscopy and Biopsy
 DOTS Strategy…the Solution!
Directly Observed Therapy Short Course

With DOTS
90% CURE RATE
 Tetanus
 Clinical Symptoms
– Increased tone in the
masseter muscle (lockjaw)
– Sustained contraction of the
facial muscles (risus
sardonicus) and back
muscles (opisthotonus)
 Tetanus

 Prevention
– Active immunization with tetanus toxoid
– Careful wound management
 Malaria

 Caused by a parasite called Plasmodium (vivax,

malariae, ovale, falciparum)
 Transmitted via the bites of infected mosquitoes
(female anopheles)
 In the human body, the parasites multiply in the liver,
and then infect red blood cells
Ergonomical Hazards
 Ergonomics

“Fitting the Job to the Worker”

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Cumulative Trauma Disorders
(CTD)
 CTD is a condition of wear and tear on tendons,
muscles and nerves which results from the
cumulative overuse and often results in pain.
 Also known as Repetitive Strain Injury (RSI)
 Ergonomic Stresses:
Health Effects
 Musculoskeletal Disorders
 Carpal tunnel syndrome
 Neck-shoulder pain
 Low back pain
 Tendonitis
 Ergonomic Stresses
Posture
 Awkward posture
 Static posture

Forceful Exertion
 Overcome weight,
resistance, inertia
 Lift, Push, Pull, Carry
 Ergonomic Stresses
Movement
 Extreme range of motion
– Twisting, bending
 Repetitive
– same motion pattern
– short cycle time
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MONITORING
• Systematic, continuous, repetitive health-related
activities that should lead to corrective action
Types of monitoring
1. Ambient / Environmental
2. Biologic
3. Medical surveillance
BIOLOGIC MONITORING
• Measurement of changes in composition of body fluids,
tissue, expired air to determine absorption of potentially
hazardous material

MEDICAL SURVEILLANCE
• Examination to determine worker’s response to the
hazard
• Clinical examination and laboratory tests
 Health Environmental Biological
Medical Surveillance
Hazard Monitoring Monitoring
Toluene Toluene in air Hippuric acid in Kidney, Liver, Brain, Skin
urine
Silica dust Silica in air None Lung status

Noise Sound level None Hearing

M. None None Lung status, sputum
tuberculosis exam.

Lifting of Observe, measure, None Symptom survey,

heavy loads document task physical exam,
radiologic exam, etc.
 Effective Workplace
Safety & Health Programs

 Can help save the health and lives of

workers by reducing hazards and their
consequences
 Have positive effects on both workers
morale and productivity
 Saves money
Essentials in the Diagnosis and
Management of Occupational Diseases

What To Do: What Not to Do:

Research the Facts Do not immediately

assume the
cause and effect of
exposure and
symptoms
Obtain more information Do not transmit
anxiety or
ignorance to the
patient
Investigate and enlist the Do not give the
help of patient, family, person work
Know the hazard - How worker is exposed
- How worker is affected

Characterize the hazard - Exposure levels

- Exposure duration

Know the worker - Susceptibilities

Obtain information on - Directed towards affected

appropriate medical organ system
examinations

Analyze medical data - Disease, recovery, rehabilitation

- Effectiveness or failure of
control measures
THANK YOU!