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OCCUPATIONAL HEALTH

ž The concept of Occupational Health (OH)

includes:
1-promoting and maintenance of wellbeing of workers at
highest degree (physical-mental add social)
2-the prevention among worker of departures from health
caused by their working conditions,
3-protection of workers in their employment from risks
resulting from factors adverse to health
4-placing the worker in an occupational environment
adapted to his physiological and psychological equipment
to summarize OH is the adaptation of work to man and to
each man to his job

OH is essentially preventive medicine

a**Both have the same aim (prevention & maintenance of
health)
b**Levels of application is the same i.e Health promotion,
specific protection, early diagnosis & treatment, disability
limitation and rehabilitation. So
OH is application of preventive medicine in all places of
employment.

- OH in modern concept include all type of

employment.
- OH in agriculture and ergonomics (human
engineering) is a new concept
-
OCCUPATIONAL ENVIRONMENT
ž Definition: The sum of the external condition
and influences which prevail at the place of work and
which have bearing on the health of working
population.
ž There are 3 types of interaction in a working
environment:
ž A- Man and Physical, chemical and biological
agents
ž B- Man and machine
ž C- Man and man
ž Physical agents:
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ž Includes heat, cold , humidity air movements,

heat radiation , light noise, vibrations and ionizing
radiation which may all adverse to health
ž These factors act indifferent ways on health
singly or in combinations
ž Amount of working , breathing space toilets
washing and bathing facilities are also imp
ž Chemical agents
ž Large no including chemicals dusts, gases,
ž They harm the body in different ways
ž Biological agents
ž Work may expose the workers to infectious
pathogens: bacteria, viruses, etc ,on contact with
animals water, soil food etc
ž Man & Machine
ž Unguarded machine or protruding or moving
parts, poor installation , lack of safety measures may
all lead to accidents, also bad posture may cause
fatigue, backache muscles or joints Ds.
Man and Man ž
Psychological factors occur in work including ž
. human relations
Examples of psychological factors include: type ž
and rhythm of work, work stability, job satisfaction,
.leadership style
Occupational component of worker cannot be ž
.separated from his domestic environment
The worker takes his worries home and bring to ž
work worries arising at home so e.g. stress at work
may disturb sleep and stress at home may affect his
work leading to accidents
ž
OCCUPATIONAL hazards
Industrial worker may be exposed to 5 types of hazards
depending on his occupation:
A. Physical Hazards
B. Chemical Hazards
C. Biological Hazards
D. Mechanical Hazards
E. Psychological Hazards
Physical Hazards
1. Heat and cold
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2. Light
3. Noise
4. Vibration
5. Ultraviolet Radiation
6. Ionizing Radiation
Heat and cold .7
Heat is common hazard .8
Direct effects :Burns, Heat exhaustion, H .9
.cramps, H stroke
Indirect effects : increased fatigue decreased .10
.efficiency, High accident rate
Radiant heat is main problem in in foundry .11
,glass ,steel indus. Stagnant heat in Jute &cotton
textile
Physical work in these conditions is very stressful and
impair health and efficiency of worker
Hazards associated with cold include:
o Chilblains,
o Erythrocyanosis,
o Immersion foot,
o Frostbite,
o General hypothermia.
Light
May harm in poor illumination or excessive brightness
• Acute effect of poor illumination : eye strain,
headache, eye pain, lachrymation, congestion around
cornea and eye fatigue
• Chronic: miners nystagmus.
Exposure to glare or excessive brightness cause
discomfort, visual fatigue. Intensive glare cause blurring of
vision that may cause accidents
Noise
Effects are of 2 types:
A-Auditory effects:= temporarily or permanent loss of
hearing.
B-Non auditory effects =nervousness fatigue, interfere
with communication, decreased efficiency
Degree of injury depend on: intensity frequency,
duration ,individual variations
Vibration
Encouraged in work in frequency 10-500Hz.
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Encountered in work with pneumatic tool such as drills and

hammers.
Affect hands and after long time Blood vessels of fingers
may become sensitive to spasm (White fingers) Also injury
to joints of hand elbow and shoulders.
Ultraviolet Radiation
Occur mainly in arc welding.
Mainly affect the eyes (intense conjunctivitis and keratitis-
welder's flash).
Symptoms are redness of the eye and pain.
Usually disappears in few days
Ionizing Radiation
Increasing applications: Radiation isotopes , X-ray.
-Imp. are cobalt 60 &Phosphorus 32.
-Some tissues are more sensitive e.g. bone marrow and
gonads.
-Hazards include genetic changes, malformation, cancer,
leukemia, ulcers, sterility and death.
-International Commission for Radiation Protection set the
maximum permissible level of occupational exposure at
5rem per year to whole body.
Chemical Hazards:
Involve most industries.
Chemical act in 3 ways:
1.Direct or local effect
2.Inhalation
3. Ingestion
Direct or local effect
ž Some chemicals causes dermatitis eczema,
ulcers, cancers by Primary effect
ž Others causes dermatitis by allergic action
ž Some are absorbed through skin and so cause
systemic effect (aromatic nitro and amino
compounds e.g. TNT and aniline)
Dermatitis is imp. problem in industry e.g. oil machine,
rubber, x-ray caustic alkalies and lime
2.Inhalation
. Gases
• Types: 1) Simple gases e.g. O2 , H2
2)asphyxiating e.g. CO, cyanide
gas ,SO2, chlorine
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3)anesthetic e.g. chloroform, ether,

trichloroethylene
**NB : CO hazards occur in coal gas manufacturing and
steel industries
. Metals and their compounds:
-chiefly enter the body by inhalation as dust or fumes

Biological hazards
Exposure to infective and parasitic agent at work may give
rise to many diseases including: brucellosis, leptospirosis,
anthrax, hydatidosis, psitocosis tetanus, encephalitis,
fungal infection, schistosomiasis.
Person working among animals products e.g. hair wool
and agricultural worker are those specially exposed to
biological hazards
Mechanical Hazards
Mainly arises from machinery, protruding and moving
parts and the like.
10% of accidents in industries are due to mechanical
causes
Psychological hazards
- These arise from worker failure to adapt to psy.
Environment
- Factors which undermine both physical and
mental health include: lack of satisfaction, insecurity,
poor human relations, emotional tension
- Capacity to adapt to different working
conditions is affected by :education, cultural
background, family life, social habits, expectation
from employer…etc
Health effects can be classified into -
A-Physchological and behavioural changes eg -
hostility, aggressiveness, anxiety,, depression,
alcoholism, sickness, absenteeism
B-Psychomotor illness include fatigue, -
headache, pain in neck. shoulder, back,
predisposition to peptic ulcer, heart diseases, rapid
aging
It is possible that physical play also a role in -
precipitating mental disorders
it is possible that new disorders may appear- -
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Also psychological will be more important than - -

Physical and chemical hazards
Occupational Diseases -
- They are diseases arising out of or in the course
of employment.
- They are usually grouped according to cause
(physical, chemical etc)
PNEUMOCONIOSIS: (pnc)
These are Ds caused by dusts ( Chemical)
They are divided into those due organic and inorganic
dusts
. ž
ž Pnc also ppt. infection eg TB
ž No cure is present so imp. is prevention
ž Most imp are:
ž 1.Silicosis
ž 2.Anththracosis
ž 3.Byssinosis
ž 4.Bagassosis
ž 5.Asbestosis
ž 6. Farmers~s Lung
ž
ž

Occupational Cancer
ž A serious problem
ž Most commonly occurs in: skin, lung, bladder
and blood forming organs
Skin Cancer
First noted in chimney sweep (affecting scrotum) in 1775
Other causes were found: coal tar, x-ray, dyes.
Account (skin cancer) for75% of Occupational cancer.
Other industries: gas worker, oven, tar, oilrefiner, road
maker, mineral oil,
Lung Cancer
o 9 /10 of lung cancer is caused by smoking, air
pollution and occupational exposure
o Lung caner occurs in: gas industry, asbestos,
nickel, chromium work, arsenic plant, radioactive
substance.
o Nickel, chromates, asbestos, coal tar,
radioactive and cigarettes smoking are proved
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carcinogens. Arsenic, beryllium isopropyl are

suspected.
Bladder Cancer
Bladder Cancer
1st noted in aniline industry then in rubber.
It is caused by aromatic amines that is metabloised in
body and excreted in urine.
Associated with industries such as dye-stuffs, rubber, gas,
electronic cable.
Leukaemia
Exposure to bezol (solvent in many industries), roentgen
rays, radioactive substances give rise to leukaemia.
It can appear long after exposure ceased.
Characteristics OF Occupational Cancer:
1.Appear after prolong exposure
2.Period bet. Exposure and development of cancer may be
as long as 10y
3.The D may develop even after cessation of exposure
4. Average age is earlier than that of cancer gen
5. Localization is constant in ant one occupation.
sible Bladder carcinogens are: Beta-naphthylamines,
benzidnes, auramine mgenta
OCCUPATIONAL CANCER
Control of Industrial cancer:
1.Elimination or control of industrial carcinogens.
Technical measures e.g. exclusion of carcinogens from
industry, well designed building or machinery, closed
system of production etc
2.Medical examination
3.Inspection of factories
4.Notification
5.Licensing of establishment
6.Personal hygiene measures
7.Education of workers and management
8.Research
OCCUPATIONAL DERMATITIS
ž dCauses:
1 Physical: heat, col, moisture, friction, pressure, X-ray
2 Chemical: Acid , alkali, solvents, dys grease, tar,
cholinarated phenols
3 Biological: biological eg viruses, bacteria fungi, etc
4 Plant products-leaves, vegetables, fruits etc
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ž Classification:
A. Primary irritants B. Sensitizing substances

ž Primary Irritants
It is the dermatitis caused by exposure
ž Allergic dermatitis
occurs to lesser degree due to sensitization of skin
PREVENTION
PREVENTION
It is largely preventable:
1. Pre-selection: To keep away from work those
with established or suspected dermatitis or those
with known pre-disposition to skin Ds
2. Protection: clothes, long leather gloves, apron
and boots, barrier creams
Personal Hygiene: Plenty supply of warm .3 .3
water, soaps and towels
Periodic Inspection: detection and treatment, .4 .4
transfer to another job, education to report any skin
irritation

Radiation Hazards
Radioactive substances e.g. radium are used in many
industries such as painting of luminous dials for watches
and other, manufacturing of radio active paints, mining, x-
ray.
Ultraviolet rays occurs in welding processes
Infrared rays occurs in welding, glass blowing, foundry
work, some painting.
Effects of Radiation:
Ionizing radiations may cause burns, dermatitis , blood
dyscrasias. Chronic exposure causes malignancies and
genetic effects, lung cancer occur due to inhalation
(Uranium mines)
Preventive Measures:
1. Avoidance of exposure or contact
2. For x-rays: shields, suitable clothing etc
3. Monitoring of employees in interval not less
than 6 months.
4. Adequate ventilation to prevent inhalation
5. Replacement and periodic examin. Every 2
months (if harmful effects occur transfer)
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6. Pregnant should not work in places of exposure.

Accidents in industry
Very common
Loss has many faces for worker: loss of wages, human
sufferings, to industries compensation costs , provision of
medical care, lowered morale, lowered production and
damage to machinery to nation loss of production
CAUSES
A Human Factors :
1. Physical
2. Physiological: sex, age, time, experience,
working hours
3. Psychological Factors
B Environmental Factors
98% are preventable, measures:
1. Adequate preplacement examination
2. Adequate training
3. Continuing education
4. Ensuring safe working environment
5. Establishing safety department with safety
engineer
6. Periodic survey for finding hazards
Preplacement examination
Done at time of employment. Purpose to place right
man in right job so he can do job efficiently with no
.(harm to health (ergonomics
E.g. it is risky to employ men suffering from certain Ds
: in certain jobs
If there is hazards of lead the followings are-
undesirable conditions: Anemia, hypertension, nephritis,
Peptic U
Dyes: asthma skin, bladder and kidney Ds-
Radiation and x-rays: signs of ill health specially any-
blood D
:Notification
According to regulation some Occupational Ds require
.notification
They are recognized internationally for worker
.compensation
Main purpose is to initiate preventive measures and to
investigate working conditions
:Housekeeping
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In industry covers general cleanliness , ventilation,

lighting, washing and general maintenance

Silicosis
It is major cause of permanent disability & mortality
Caused by inhalation of dust containing free silica or
silicon dioxide
Occurrence is associated with following industries:
mining industries, pottery, ceramic, sand blasting metal
grinding building and construction work, iron and steel
industries.
Incubation period varies bet .few month to 6years
depend on chemical composition ,size ,duration and
individual susceptibility
Path.: Particles are ingested by phagocytes which
accumulate & block lymphatics. There is fibrosis
(characteristic)
Clinically: onset insidious there is cough ,dyspnea on
exertion and pain. Decrease TLC.
X ray :Snow-storm.
Pts prone to TB…SilicoTB.
N0 effective Rx. Control is by :
- dust control measures (good cleaning, isolation…etc
- Regular physical exam.

Anthracosis
There are 2 phases in coal miners Pneumoconiosis –
inorganic coal dust:
1.Simple Pn- 1st phase-associated with slight pulm.
Impairment. may require 12 years of work exposure
2.Progressive massive fibrosis (PMF): severe respi.
disability and premature death.
Once the 1 background fibrosis may develop 2 occur
without further exposure.
Risk of death increases than other population
In some countries it is notifiable disease &
compensatable.
Byssinosis
It is due to inhalation of cotton fibres duts.
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Symptoms are chronic cough and dyspnoea ending in

chronic bronchitis and empysema
BAGASSOSIS
It is a lung D characterized inhalation of bagasse or
sugar-cane dust
- It is due to an actinomyces.
- Symptoms consist of breathlessness, cough
,hamoptysis, fever
- Causes brocholitis, mottling of lung or shadow
- If treated early there is resolution if not there is
fibrosis, emphysema and bronchoiectasis.
Preventive Measures:
1. Dust control (wet, enclosed apparatus, exhaust
ventilation etc )
2. 2.Personal protection: Mask, respirator with
mechanical filter or O2
3. Medical control: initial exam. &periodic
Bagasse control: by keeping moisture content above
20%, spraying with 2%propionic acid (fungicide

ASBESTOSIS
Asbestos = commercial name for fibrous material.
Chemically: silicates where silica combined with Mg, Fe,
Ca , Na and Al. It is of 2types A)Serpentine or chrysolite
-90% B)amphibole Fibers are 20-500m
- It is used in: manuf. Of asbestos cement, fire
proof textiles, brake lininroof tiling, mined in some
places and imported from USSR, US, south africa..etc.
- It enters the body by inhalation, fine dust
deposit in alveoli causing pulmonary fibrosis leading
to resp.insufficency and death Ca of bronchus
,pleura,and GIT
- More harm occurs if exposure is accompanied
with cigarette smoking
- Clinically : dyspnoea out of proportion to clinical
picture, finger clubbing, cardiac stress and cyanosis.
- Sputum shows asbestos bodies (asbestos with
fibrin) .Xray =ground glass appearance.
- D is progressive even if pt. is removed from
exposure.
- Preventive Measures:
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- 1)use of safer type of asbestos(Chrysolite and

amosite) 2)subsituation of other insulant 3)good dust
control 4)periodic exam 5)continuing research

FARMER LUNG
It is due to inhalation of mouldy hay or grain dust.
With moisture bacteria and fungi grows causes rise in
temp. that encourage growth of actinomycetes
Acute illness is characterized by general ,resp. signs
Repeated attacks causes pul. fibrosis and corpulmonale

LEAD POISONING
Lead used widely in industries more than any other
metal for:1.boiling point is low 2. easily mix with other
metal to form alloys 3. easily oxidizes 4. anticorrosive
All lead cps. Are toxic i.e. lead arsenate and carbonates
while lead sulphide is least toxic.
Industrial uses: batteries, glass, ship-building, printing ,
potteries, rubber… etc
Non-occupational: gasoline exhausted from
automobiles. exposure may arise via drinking water
(lead pipes) some paints in windows sills or toys in
children
Mode of absorption:
1. Inhalation: Most cases are due to inhalation
2. Ingestion: From R.T or from foods and drinks by
contaminated hands
3. Skin: only occur in organic
• Normal level in blood 25 microgram .Symptoms
occur above 70
• 90% of ingested is excreted in faeces
• 95% of absorbed enters the circulation, 95% go
into RBC then Liver, Kidney and Bones where it is laid
down, it can be released sometimes to soft tissues
• Clinical Picture:(Plumbism):different in organic
and non-organic poisoning
• In organic: mostly in CNS in form of insomnia
headache, confusion, delirium.
• In inorganic: abdominal colic, constipation, loss
of appetite , blue line in the gum, stippling of RBCs,
anaemia, wrist drop, foot drop
DIAGNOSIS
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 In organic: mostly in CNS in form of insomnia

headache, confusion, delirium.
 In inorganic: abdominal colic, constipation, loss
of appetite , blue line in the gum, stippling of RBCs,
anaemia, wrist drop, foot drop
DIAGNOSIS
Based on
1.History
2.Clinical features
3.Lab Tests: a) coproporphyrin in urine…screening test
b)amino levulinic acid in urine
c)Lead in blood and urine
d)Basophilic stipling of RBC..sensitive
PREVENTIVE Measures;
1- substitution (change cps by less toxic)
2.Isolation (of activities generating lead)
3.Local exhaust ventilation
4. Personal protection (by approved respirator)
5. Good housekeeping
6. Working atmosphere.(should be below 2 mg per 10cu
m)
7.Periodic exam. Of ALL workers.
8.Personal hygiene.
9.Health education.

Management:
Major objective is prevention of further absorption.
Removal lead from soft tissues and prevention of
recurrence.
early recognition help remove pt. from exposure. Saline
purge remove un absorbed lead from the gut.
Penicillamine is effective, like Ca-EDTA (chelating agent
promote lead excretion in urine.)
Lead Poisoning is notifiable and compensating D in
some countries

PHC
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