Unit =9

Measures of health promotion of workers

PREPARED BY
SAMJHANA NEUPANE
Msc Nursing 2nd year
SNSR
 GENERAL OBJECTIVES

• At the end of the session the participants will be able to explain about
measures of health promotion
 SPECIFIC OBJECTIVES

To Introduce about occupational health.

To define the occupational health.

To list the aim of occupational health.

To enlist the objectives of occupational health.

To define occupational health nurse.

To explain about occupational health hazards.

To explain about health promotion of health workers.

To describe the prevention of occupational hazards.

To state the key principles of occupation safety and health management.

To list the elements of occupational health safety and management.

To enlist the approaches of health safety.

To describe the role of occupational health nurse.

 INTRODUCTION
• Just like home the place of work is also an important environment for an
earning person.

• Such a person spends nearly 6-8 hours a day in the working place till the
retirement for about 3 decades.

• Not only the worker should be healthy but the environment. Should also be
healthy, safe & free from harmful agents.

• “Occupation health is concerned with man in all occupations”

Occupational health

• Refers to the potential risks to health and safety for those who work
outside the home Hazard

Hazards:

• something that can cause harm if not controlled.

Occupational disease

• Disease directly caused by a person’s occupation.

 Definition of Occupational Health:

• "Occupational health should aim at the promotion and maintenance of the

highest degree of physical, mental and social well-being of workers in all
occupations
• the prevention among workers of departures from health caused by their
working conditions;
• the protection of workers in their employment from risks resulting from
factors adverse to health.”
• the placing and maintenance of the worker in an occupational environment
adapted to his physiological and psychological equipment, and, • to
summarize, the adaptation of work to man and of each man to his job
• The Joint ILO/WHO Committee on Occupational Health,1950 .
• “OCCUPATIONAL HEALTH is the promotion & maintenance of the
highest degree of physical, mental & social wellbeing of the workers
in all occupations”.
 AIMS OF OCCUPATIONAL HEALTH

• “The promotion and maintenance of the highest degree of physical,

mental and social well-being of workers in all occupations"
 OBJECTIVES OF OCCUPATIONAL HEALTH

3. To adapt the
1.To maintain 2. To work place and 4. It should
work
and promote the prevent environment to be
physical, mental
and social well occupationa the needs of the preventive
workers i.e
being of the l diseases application of
rather than
workers. and injuries. curative.
ergonomics
principle.
 Occupational Health Nurses (OHN)s

• Occupational Health Nurses (OHN)s are registered nurses who

independently observe and assess the worker's health status with respect to
job tasks and hazards. Using their specialized experience and education,
these registered nurses recognize and prevent health effects from
hazardous exposures and treat workers' injuries/illnesses.
 Occupational safety and health (OSH)

• Occupational safety and health (OSH) also commonly referred to as

occupational health and safety (OHS) or workplace health and safety
(WHS) is an area concerned with the safety, health and welfare of people
engaged in work or employment.
 OCCUPATIONAL HAZARDS
An industrial worker is exposed to 5 types of hazards
depending upon the nature of the occupation.

PHYSICAL

CHEMICAL

BIOLOGICAL

MECHANICAL

PSYCHOSOCIAL
Types of occupation

Agricultural Workers
Industrial Workers
Mine Workers
Professionals
Health Workers
Construction Workers
Carpenters Etc...
 HEALTH PROMOTION OF WORKER

Recommendation By Ilo/Who • Nutrition

Committee On Occupational • Communicable disease control
Health By 1953 • Environmental sanitation
• Mental health
• Measures for women and children
• Health education
• Family planning
 NUTRITION

• Malnutrition

• Canteen /250 workers

• Diet and snacks at reasonable rates

• Store /dining room

• Health education
 COMMNICABLE DISEASE CONTROL

• Early diagnosis/Rx

• Cases isolated from working environment

• Protective measures

• Regular Medical checkup & Immunisation

• TB,Typhoid,hepatitis,mala ria, venereal diseases

 ENVIRONMENTAL SANITATION

• Water supply
• Food
• Toilet
• General cleanliness
• Space
• Lighting
• Ventillation/Temperature
• Protection from hazards
 MENTAL HEALTH

• Promote health and happiness

• Detect signs of emotional stress

• Identify the cause

• Treatment

• Rehabilitation of the ill

 MEASURES FOR WOMEN &CHILDREN

• Maternity leave for 12 weeks with cash benefit under ESI act

• Ante/Intra/Postnatal services

• Prohibition of night work

• Prohibits of work underground

• Crèches

• No child below 14 shall be employed

 HEALTH EDUCATION

• Important health promotional measure

• Provided whenever necessary

• Content – Hygiene, participation

• At all levels – Management – Supervisors – Workers – Trade union leaders

 FAMILY PLANNING

• Encouraged to adopt small family norm

• Health education
PREVENTION OF OCCUPATIONAL DISEASES

MEDICAL
MEASURES

LEGISLATIVE ENGINEERING
MEASURES MEASURES
 MEDICAL MEASURES

• Pre Placement Examination

• Periodical Examination
• Medical & Health Care Service
• Notification
• Supervision Of Working Environment
• Maintanance & Analysis Of Records
• Health Education & Counselling
 ENGINEERING MEASURES

• Design of building

• Conduct air monitoring to measure the workers’ exposure to crystalline silica.

• Minimize exposures by controlling the creation of airborne particles, for

example, use wet drilling, local exhaust ventilation.

• Personal Protective Equipments: Provide workers with protective clothes,

respiratory protection, and facilities for washing (showers) and changing. o
Enclosure / isolation o Environmental monitoring
 OTHERS MEASURES

• Legal measures: Measures to minimize dust emissions and exposure to

dust.
• Law compliance mechanisms, including effective workplace inspection
systems
• Cooperation between management and workers and their representatives
• A mechanism for the collection and analysis of data on occupational
diseases
• Collaboration with social security schemes covering occupational injuries
and diseases
• Training of health professionals in occupational diseases as majority
of medical practitioners lack training in occupational health and
consequently lack the skills to diagnose and prevent occupational
diseases.
 KEY PRINCIPLE IN OCCUPATION SAFETY AND HEALTH
MANAGEMENT
• All workers have rights
• Occupational safety and health policies must be established.
• A national system for occupational safety and health must be established.
• A national programme on occupational safety and health must be
formulated.
• Continuous improvement of occupational safety and health must be
promoted.
• Information is vital for the development and implementation of effective
programmes
• Health promotion is a central element of occupational health practice.

• Occupational health services covering all workers should be established.

• Compensation, rehabilitation and curative services must be made available to

workers who suffer occupational injuries, accidents and work related diseases.

• Education and training are vital components of safe, healthy working

environments .

• Workers, employers and competent authorities have certain responsibilities,

duties and obligations .

• Policies must be enforced.

 ELEMENTS OF OCCUPATIONAL HEATH SAFETY
MANAGEMENT SYSTEM

1.Organisation, Responsibility, Accountability

• Senior manager/involvement

• Line manager/supervisor duties

• Management accountability and performance measurement

• Company OHS policy

 2.CONSULTATIVE ARRANGEMENTS

• Health and safety representatives - a system resource o Issue resolution –

• HSR/employee and employer representatives

• Joint OHS committees

• Broad employee participation

 3. Specific Program Elements

• Health and safety rules and procedures

• Training program
• Workplace inspections
• Incident reporting and investigation
• Statement of principles for hazard prevention and control
• Data collection and analysis/record keeping
• OHS promotion and information provision
• Purchasing and design

• Emergency procedures

• Medical and first aid

• Monitoring and evaluation

• Dealing with specific hazards and work organisation issues

APPROACHES TO OCCUPATIONAL HEALTH SAFETY

Commitment to a Safe Workplace

(framing a policy based on consultation).
Recognising and Removing Dangers
(using a danger identification list).
Maintaining a
Safe Workplace
Safety Records
and Information
 ROLE OF COMMUNITY HEALTH NURSE IN
OCCUPATIONAL HEALTH AND SAFETY

1. Clinician

• Primary prevention

• Emergency care

• Treatment services

• Nursing diagnosis

• Individual and group care plan

• General Health advice and health assessment

• Research and the use of evidence based practice

 Specialist
• Occupational health policy, and practice development, implementation and evaluation
• Occupational health assessment
• Health surveillance
• Sickness absence management
• Rehabilitation
• Maintenance of work ability
• Health and safety
• Hazard identification
• Risk assessment
• Advice on control strategies
• Research and the use of evidence based practice
 Manager

• Management

• Administration

• Budget planning

• Marketing

• Service level agreements

• Quality assurance

• Professional audit

• Continuing Professional development

 Co-ordinator

• Occupational health team

• Worker education and training

• Environmental health management

 Adviser

• To management and staff on issues related to workplace health

management
• Agencies
Health educator

• Workplace Health promotion

• Counsellor
• Counselling and reflective listening skills
• Problem solving skills
 Researcher

• Health needs assessment

• Research skills

• Evidence based practice

• Epidemiology
 Disability

• According to the World Health Organization, a disability is any

restriction or lack (resulting from any impairment) of ability to perform an
activity in the manner or within the range considered normal for a human
being”
 TYPES
• It is classified into two groups:

• 1) Event type indicators

• Number of days of restricted activities.

• Bed disability days.

• Work loss days within a specified period.

• 2) person type indicators

• Limitation of mobility

• Limitation of activity
The sequence with which a disease turns into a handicap is as
follows :

Disease Impairment Disability handicap

 DISEASE

• This is a pathological process and it’s manifestations which indicate a

departure from the state of perfect health.

IMPAIRMENT

• This is the actual loss or damage of a part of body anatomy or an

aberration of the physiological functions that occurs consequent to a
disease.
 DISABILITY
• Disability is any restriction or lack (resulting from any
impairment) of ability to perform an activity in the manner or
within the range considered normal for a human being
Handicap

• This is the final disadvantage in life which occurs consequent to

an impairment or disability, which limits the fulfillment of the
role a person is required to play in life.
 REHABILITATION

• MEANING OF REHABILITATION

• It is restoration of ability to function. It is to support the patient with an

injury or disability illness to achieve maximum function and independence
 DEFINITION

• W.H.O define rehabilitation as “the combines and coordinated use of

medical, social, educational and vocational measures for training the
individual to the highest level of functional ability”

• Rehabilitation is a treatment designed to facilitate the process of recovery

from injury, illness, or disease to as normal a condition as possible.
Principles of rehabilitation:

Rehabilitation should begin during the initial contact with the patient
The emphasis of rehabilitation is to restore the patient in independence or pre-
illness or pre-injuries level of function in as short a time as possible

He must be an active participant.

Motivates the patient and help him to attain social independence

Focus is on needs of group of people with specific condition.

Every patient has right to the rehabilitation services.

Types of Rehabilitation:
• Medical Rehabilitation: help a person better in all his daily physical and mental
activities. Related to increasing the potential capabilities and correction of deformities,
restoration of functions.

• Social Rehabilitation: Implies social life; restoration of family, social interactions or

relationship .

• Psychological Rehabilitation: Includes psychological restoration of personal dignity

and confidence of the disabled.

• Vocational Rehabilitation: help those patient who find it difficulty to get employment
BASED ON TREATMENT TYPES:

• Cardiopulmonary Rehabilitation.

• Physical Rehabilitation

• Speech Rehabilitation.

• Occupational Rehabilitation.

• Psychological Rehabilitation.
CARDIC REHABILITATION:
Cardiac Rehabilitation Program is committed to providing
comprehensive risk factor management to our patients with
cardiovascular disease.

PHYSICAL REHABILITATION:
Physical rehabilitation helps the patient restore the use of muscles, bones
and the nervous system through exercise and other technique.
• OCCPATIONAL REHABILITATION:

• Occupational rehabilitation helps the patient regain the ability to do normal

everyday tasks. This may be achieved by resting old skills, or teaching the
patient new skills to adjust to disabilities through adaptive equipment,
orthotics and modification of the patient’s home. The therapist will visit the
patient’s home and analyze what the patient can and cannot do.
• SPEECH REHABILITATION:

• Speech therapy helps the patient correct speech disorders or restores speech.
It involves regular meetings with the therapist in an individual or group
setting and home exercises.

• E.g. To strengthen muscles, the patient might be asked to say words, smile,
close, his mouth. Or stick out his tongue.

• Picture cards may be used to help the patient remember everyday objects and
increase his vocabulary.
PSYCHIATRIC REHABILITATION:

• Psychiatric rehabilitation involves helping people with mental illness, gain or

improves skills while obtaining the necessary resources and support in reach
their goals.
Multidisciplinary team: it is when many different
professionals work together towards a common
goal .

Intradisciplinary rehabilitation team: a team of

professionals who are all from the same professions
, such as three therapist collaborating on same case.

Transdisciplinary rehabilitation Team: a team

composed of member a number of different
professions co- operating across discipline to
improve patient care through practice or research.
• Core member it includes family member.
 Essent
ial Therap
Role of Co-
eutic Educato counsel
rehabilitat nursin ordinato
practic r
Advisor
or
ion nurse r
g e
skills
 Summary

• Today we discussed about introduction of occupational health, its

introduction, types of occupation , key principles, disability and
rehabilitation.
• “OCCUPATIONAL HEALTH is the promotion &
maintenance of the highest degree of physical, mental &
social wellbeing of the workers in all occupations”.
• There are different occupational hazards such as
physical,chemical,biological, mechanical and psychological.
• ILO recommends these things Nutrition Communicable
disease control ,Environmental sanitation, Mental health,
Measures for women and children, Health education, Family
planning for the promotion of health workers.
• Rehabilitation is needed by an increasing number of individuals because the
ability to live longer, productive life with multiple chronic conditions.

• Nurses in acute care settings have an important role to identifying who will
benefit from rehabilitation services.
 Evaluation

What is occupational health ?

What are th
e measures
promotion for
of health w
orkers?

What is rehabilitation and types of

rehabilitation?
 REFERENCES:

• Park.k (2019). Textbook of Preventive and social medicine. 25th edition.

Bhanot publication . Page no 775-800

• Gukani. K.K (2019). Community Health Nursing. Kumar publication.page no

556-560

• B.T. Basavanthappa, Community health nursing, Jaypee Publication, 6th

edition, Page no. 584-605.
• https://www.slideshare.net/stephipoulose/occupational-health-55324122
• https://www.slideshare.net/rushikeshpawar779/occupational-health-54901941
• https://www.slideshare.net/sameekshabhardwaj1/occupational-health-occupat
ional-hazards
• https://www.who.int/occupational_health/regions/en/oeheurnursing.pdf?ua=1
• http://whqlibdoc.who
• www.cbr.rehab.co.in
• www.rehab.org.in