Occupational Health

Dr. Elizabeth Nji

• OCCUPATION-: This can be seen as a routine job in which one
specialises or engages in order to earn a living e.g. welding, farming
and timbering.
• HEALTH: According to WHO 1948; Health is a state of complete
physical, mental, and social well-being of an individual, not merely the
absence of disease or infirmity.
• SAFETY-: This simply means the state of being safe. It is the condition
of being protected from harm or other non-desirable outcomes.
• According to World Health Organization (WHO) "occupational health deals with all aspects of
health and safety in the workplace and has a strong focus on primary prevention of hazards."
• Occupational health is a multidisciplinary field of healthcare concerned with enabling an
individual to undertake their occupation in the way that causes least harm to their health. It
aligns with the promotion of health and safety at work.
CONCEPTS OF OCCUPATIONAL HEALTH AND SAFETY
• Occupational health and safety are activities, processes or strategies to protect and promote the
health and safety of workers, enhances and supports the development and maintenance of their
working capacity and social development at work (Premier occupational health, 2010).
• Therefore occupational health is a branch of public health that deals with the promotion and
protection of workers health. It can also be defined as the maintenance and promotion of the
highest degree of physical, mental and social wellbeing of workers in all occupation.
 RATIONALE FOR OCCUPATIONAL
HEALTH AND SAFETY
Workers need to be provided special services because of the following reasons:
• 1. People whose works are very important to every community because the money they
receive helps the community to develop or progress. This is because without money, social and
educational development cannot take place. Therefore, workers must be healthy and made
happy all the time most especially at their workplace.
• 2. Workers may be exposed to special health risks at their place of work.
• 3. They may work in very isolated or remote areas where no other health services are
available.
• 4. There may be many people at one workplace, so, it is more economical to bring services to
them rather than to make them seek for health services elsewhere or outside their workplace.
• 5. The worker utilizes about one-third of the day in the workplace; there is therefore a need to
ensure a healthy work environment and the interest of the employee, the employer and the
society must be taken into consideration.
 GOAL, AIM AND OBJECTIVES OF
OCCUPATIONAL HEALTH
• The goal of an occupational safety and health program is to foster a safe and healthy occupational
environment. OHS also protects the general public who may be affected by the occupational
environment.
• The aim of OH is to ensure that workers health are safeguarded in their workplace.
The objectives of occupational Health as defined at the first session of the Joint Committee of World
Health Organization and International Labour Organization in 1950 are as follows:
• The promotion and maintenance of the highest degree of physical, mental and social well being of
workers in all occupations.
• To prevent and reduce the risk of injury and health impairment of workers arising from exposure
to the hazards in the working environment.
• The protection of workers in their employment from risks resulting from factors adverse to health.
• To provide a work environment free of health hazard.
•
• To increase the size of the occupational sector and their various
contributions to all round development of the society.
• To generate awareness and create a safety consciousness in the
workers of various categories.
• To create health facilities and services that are easily accessible and
available.
• To maintain and sustain an existing relationship between the workers
and the management.
• The adaptation of work to man and each man to his job.
 ADVANTAGES OF OCCUPATIONAL
HEALTH AND SAFETY
A lot of advantages have been identified in effective administration of occupational health and safety
programmes both to the employer, the employees and the community at large. They are as follows:
• Enactment of laws specifying payments to workers for industrial accidents or for illnesses caused by
occupation.
• It helps workers to become enlightened that their rights are well preserved and that their duties are well
defined and attended to.
• It ensures suitable job placement.
• It promotes physical, social and mental wellbeing.
• It portends better health and ensures longer life.
• It lowers personal medical cost.
• It sustains employee earnings.
• It ensures greater job satisfaction.
• It contributes to the prosperity of the community.
• It decreases welfare costs and improves public relations.
 Responsibilities of the Employers
To prevent sickness and accident and to promote health and efficacy, the condition
under which people work have to be conducive. Apart from being conducive, it
must be safe.
To achieve this, the following should be considered:
1. pre-employment medical examination.
2. Provision of adequate training for all the workers.
3. Regular workshop and seminars.
4. Provision of canteen services to enable the workers to take balance diet.
5. Understanding and cooperation among employer, management and employee.
6. Job satisfaction i.e motivation and promotion.
7. Provision of transport facility.
8. Good medical services e.g Health Insurance Scheme.
9. Provision of firefighter equipment.
10. Adequate provision of portable water supply.
11. Periodic medical examination.
12. Substitution of workers.
13. Prompt payment of salary and allowances.
14. Provision of personal protective equipment.
15. Health education.
When all these are provided, the workers will be healthy, sickness and
absenteeism will be reduced, there would be efficiency and high productivity
 COMPONENT OF OCCUPATIONAL
HEALTH AND SAFETY
It is basically divided into three:
1. Occupational medicine.
2. Occupational/Industrial hygiene and safety services.
3. Industrial welfare services.
OCCUPATIONAL MEDICINE
This is a branch of preventive medicine with some dose of therapeutic functions carried out by the
occupational health physician and his team towards ensuring a total health for every worker.
Occupational medicine centres on preventive medicine and management of illness, injury or disability
related to workplaces.
This includes:
Medical examination: In view of the fact that unhealthy workers may pose danger to their colleagues,
families and communities. There is a need for medical examination of workers. The main aim is to highlight
past medical history, known drug allergies, family predisposing influences, clinical conditions and medication
history of all potential workers before and during employment.
The health implication of medical examination is to ensure that suitable potential employees are placed on
the job that suits their anatomical, physiological and psychological make up.
The medical examinations therefore include:
• Pre-employment medical examination.
• Pre-placement medical examination.
• Periodic medical examination.
• Treatment of all occupational associated ailments.
• Family health services.
• Rehabilitative health services.
• Pre-employment medical examination: this is the type of examination carried out on the
proposed worker who wishes to work in a particular job. This is carried out on all new
employees to ensure suitability of the individual’s state of health. It provides a baseline data on
the health status of the potential employee. The aim of conducting this test is to determine
whether the proposed employee’s health will allow him fill the position in question. It is usually
carried out by occupational health service of the establishment or affiliated health institution.
• Pre-placement medical examination: this is also called post-offered medical examination. It is a
medical examination conducted after an employee has been extended a job offer but has not
been placed in a position.
• Pre-placement medical examination may take place prior to placement of a proposed worker in
a new job or following the challenging health problem faced by the worker in a particular job,
hence, the need to change the position in the same establishment. Placement examination will
enable the management to know where the worker in question can function even with his
challenges.
• Periodic medical examination: this is the type of examination carried out on
workers from time to time to determine their health while on the job and to
detect some deviation from health caused by their working conditions and other
factors adverse to health. Periodic medical examination is carried out on every
worker including those with no medical problems. The aim apart from detection of
incipient disease is to evaluate and for the adjustment of the individual to his
environment. It might be carried out every three month, 6 month or yearly,
depending on the nature of the work and the working environment.
• Family Health Services: medical care should not only be given to the workers but
an extension should be made to cover their families especially the immediate
family. This is because even if the worker is fit and sound, he/she can not still
perform well if his/her family member is sick or has any problem/challenge health
wise.
• Rehabilitative Health Service: rehabilitation is the process of
restoring a disabled person to a condition in which he is able to
resume normal life as early as possible. This involves integrated
approach such as medical treatment, vocational training and
resettlement in an employment as well as helping the person to
adjust socially and emotionally to his/her present state.
• An occupational rehabilitation is the science and practice of retiring
injured workers to a level of work activity that is appropriate to their
functional and cognitive capacity both of which are influenced by the
severity of the workers injury.
2. OCCUPATIONAL/INDUSTRIAL HYGEINE AND SAFETY SERVICES
According to British Occupational Hygiene Society (BOHS), industrial hygiene is the
science concerned with the identification, measurement, appraisal of risk and control to
acceptable standard of physical, chemical and biological factors arsing in or from work
place, which may affect the health or wellbeing of those at work in or the community.
Industrial/Occupational Hygiene practice can be summarized below:
• Evaluation of actual potential hazards in work environment.
• Raw materials sampling for toxicity as well as explosion.
• Storage of radioactive and toxic substances.
• Work place assessment/survey.
• Engineering control of plants and devices.
3. INDUSTRIAL WELFARE SERVICES

These are the provisions specially arranged for workers to benefit from workplace during working hours.
These are services and provision aimed at boosting the morale of workers. Welfare services includes:
• Provision of educational facilities, aids and assistance to the children of the workers such as scholarship,
books, etc.
• Provision of recreational facilities such as sporting facilities.
• Provision of Life and Health Insurance Schemes
• Provision of shift duty allowances
• Provision of hazard/risk allowances
• Provision of free housing/accommodation as well as housing loan to enable workers own houses of their
own
• Provision of transportation facilities
• Provision of subsidized but standard cafeteria or restaurant services.
• Provision of sanitary convenience (with separate rest rooms for male and female.)
• Provision of Cloak room.
 OCCUPATIONAL DISEASES
• Occupational disease is any illness associated with a particular occupation or
industry. Such diseases result from a variety of biological, chemical, physical,
and psychological factors that are present in the work environment or are
otherwise encountered in the course of work.
• Each occupation is associated with its own disease; hence, effort will be made
to address different types of occupational diseases and how to prevent them.
Some Categories of Occupational diseases
• 1. Occupational Lung diseases
• 2. Occupational Dermatitis
• 3. Occupational Cancer
1. OCCUPATIONAL LUNG DISEASES
These group of occupational lung diseases are caused by inhalation of dust, fume, gases, vapour.
Dust is formed when earthly materials are reduced to small size by grinding, crushing, drilling and blasting. The
particles vary from 1 to 200 micrometre.
The main dust induced diseases are:
A. Pneumoconiosis
B. Byssinosis
c. Extrinsic Allergic Alveolitis
A. Pneumoconiosis
This is a group of disease which results from the effect of inhalation of various mineral dusts on lungs. Each
disease maybe characterised by chronic fibrotic change.
1. Silicosis: this is caused by inhalation of free Silica dust. It is common among grindstone cutters, quarry
workers, pottery workers, workers in cement factories, sand miners, stone crushers, glass making industries,
bricklayers, etc.
Signs and symptoms
• May initially be symptomless
• Dyspnoea followed by total incapacitation
2. Asbestosis: this is an occupational disease caused by inhalation of fine asbestos dust. It is
common among workers of asbestos cement factories, asbestos heat insulation, ceiling board,
locomotive break pad factory, shipyards.
Signs and symptoms
• Progressive breathlessness,
• Unproductive cough becoming mucoid,
• Weight loss
• Grey cyanosis
• Decreased lung total capacity,
• Finger clubbing
3. Coal workers pneumoconiosis: caused by inhalation of coal dust or in mixture with silica. It is
called Anthracosis when caused by coal dust but Anthrasilicosis when caused by mixture of coal
dust with Silica. Common among coal miners, foundry workers, welders, haematite miners
Signs and Symptoms
Breathlessness, weight loss, heart failure, fever, cough.
B. Extrinsic Allergic Alveolitis (EAA)
These refer to a group of lung diseases that can develop after exposure to certain substances.
The name describes the origin and the nature of these diseases;
 Extrinsic- caused by something originating outside the body
 Allergic-an abnormally increased (hypersensitive) body reaction to a common substance
 Alveolitis- inflammation in the small air sacs of the lungs (alveoli)
EAA is a lung disorder resulting from repeated inhalation of organic dust, usually in a specific
occupation setting.
Symptoms can include:
Fever, cough, worsening breathlessness and weigh loss
In the acute form, respiratory symptoms and fever begin several hours after exposure to the
dust.
Typical examples are:
1. Bagassosis: caused by inhalation of dust from mouldy bagasses or sugar cane dust.
• It is characterized by fever, dyspnoea, breathlessness, haemoptysis. Diffuse bronchiolitis
can also develop as a result of bagassosis. Occupational exposure include workers of
sugar industries, manufactures of fibreboards, those who dispose sugar cane wastes.
2. Farmer's Lungs: this is probably the most common occupational form of EAA. It is an
allergic response usually caused by breathing in the dust from mouldy hay. It is the
outcome of an allergic response to a group of microbes, which form mould on vegetable
matter in storage.
It occurs among agricultural workers exposed to dusts from mouldy crop (hay, straw, corn,
silage, grain).
It may also occur among local mattress makers who use dry straw in their trades. During
the handling of mouldy straw, hay or grain, particularly in a confined space such as a
poorly ventilated building, inhalation of spores and other antigenic materials is very likely.
• It is characterized by sudden onset of fever, dyspnoea, no appetite, Malaise,
breathlessness, dry cough and evening fever.
General Prevention against Occupational Lung Disease
1. Ventilation: dust should be controlled at source through installation of exhaust
ventilation.
2. Wet method: application of water to suppress dust with the main objective of
preventing the dust from becoming airborne.
3. Regular medical examination.
4. The use of personal protective devices such as face mask, nose masks, respirators.
5. Health education.
6. Substitution method.
7. Limitation of exposure.
8. Enclosure of dusty process.
Occupational Dermatitis
• This is an occupational skin disease characterized by local inflammation of the skin
resulting directly from or aggravated by the working environment. It occurs in
workers of all ages and in any work setting. It is the most common occupational
disease and responsible for enormous loss of working hours. It causes a great deal
of illness, anxiety and reduced productivity and efficiency. The frequency of
occupational contact dermatitis has been discovered to be directly proportional to
the level of hygiene practice among workers and in the workplace and generally the
disease is preventable.
• Skin disease constitute 50% of all occupational diseases. Substances used in various
industries may affect workers resulting in skin problems or allergic reactions.
Poisoning may occur from toxic chemicals from soap manufacturing industries,
pharmaceuticals, chemical, textile industries.
Causes
The causes of contact dermatitis are chemical, physical, mechanical and
biological agents
1. Physical factors: physical factors such as heat, cold, ultraviolet light from
sunlight are capable of damaging skin.
• High temperature causes perspiration and softening of the outer layer of
the skin resulting in heat rash common among workers working outdoors in
humid weather, bakeries and steel rolling mills.
• Exposure to low temperature can cause frostbite among workers in cold
rooms. Frequent handling of frozen food can permanently damage blood
vessels.
2. Mechanical factors: friction or pressure can produce some types of mechanical trauma.
This may result in burn, abrasion or more commonly ‘’callosities” produced by repetitive
type of hand motions, for example vibration from a road digging machine. Other groups
are carpenters, floor sweepers, farm workers and cobblers
3.Chemical factors: the chemical factors are divided into two main types. These are
primary skin irritants and secondary sensitizers.
General Prevention against Occupational Dermatitis
• The use of PPE
• Personal hygiene
• Proper pre-selection of workers
• Periodic inspection
• Periodic medical examination
Occupational cancer
Cancer is a condition which describes an uncontrolled growth of cell, which by size, shape, and
relation to surrounding structures can displace, erode and later alter the functions of healthy
organs. Percival Pott in 1775 established an association between scrotal cancer and chimney
sweeps. The sites mostly affected are skin, lungs, bladder and blood cells
• Lung cancer: this is an occupational cancer among workers engaged in mining or handling of
nickel, chromium, asbestos and iron ore. It is due to inhalation of dust, hydrocarbon, fume,
cigarette substances, tobacco smoke.
• Skin cancer: this is due to exposure to pitch tar, shale oil, radioactive materials and ultraviolet
light from the sun. Statistics shows that about 75% of all occupational cancer are skin cancer.
• Cancer of the bladder: this occurs among workers engaged in the manufacturing of dyes, drugs
(pharmaceuticals), rubber and plastics. It is caused by aromatic amines used as intermediate
amines used for manufacturing of substances. Cancer of the bladder was first noted in man in
aniline industry in 1895.
• Leukemia: this is cancer of the blood caused due to exposure to benzol, roentgen rays and
radioactive substances. Benzol is a dangerous chemical and is used as solvent in many
industries. Leukemia may appear long after exposure has ceased.
Characteristics of Occupational Cancer
• 1. Appears after a prolong exposure. The period between exposure and development of the
disease may be as long as 10-20 years
• 2. It can appear even after cessation of exposure
Prevention and Control of Occupational Cancer
• Medical examination
• Elimination or control of industrial carcinogen such as substitution, exclusion of carcinogen
• Early diagnosis
• Environmental sanitation/personal hygiene
• Health education of workers
• The use of personal protective devices
• Inspection and licensing of factories.