Occupational hazards in special

areas

Margaret K. Semakula

11/5/2014

Margaret

Introduction

Certain occupational groups are at a heightened risk of

hazardous exposure than others the world over.

The agricultural sector is one of the occupational areas that use

the highest amounts of chemicals.
Others include miners, health care workers etc.
The occupational health issues affecting vulnerable persons or
population is an important aspect especially in developing
countries.
Women, children, the disabled, the migrant workers and the
elderly face a great range of hazards because of their attributes
some of which are socially constructed & others rooted in
physiology.
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Introduction
The are a number of areas or occupations faced with
occupational hazards but for the purpose of this course the
following will be covered;
1. Occupational health in agriculture

2. Occupational health in the service industry

3. Occupational health among vulnerable groups

4. Occupational health issues affecting women

5. Reproductive health hazards
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Challenges at workplace In Uganda

Management support-Look at it as a cost not as
an investment
Lack of safety responsibility and accountability
Changes in attitude and behaviors to develop the
culture of safety and health.
Limited number of Safety and health officers and
inspectors
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Challenges at workplace In Uganda

Inadequate resources for effective enforcement of
legislation
Inadequate and incompetent safety supervision at
workplace.

Lack of awareness and understanding of safety and

health regulations and general labor laws.
Improvisation
House keeping
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Challenges at workplace In Uganda Contd

Lack of OH&S information, training materials,
courses and programs which the Ugandan
companies could utilize.

Lack of thorough reporting of incidents and

accidents
Unskilled personnel hard to understand why
safety- Contractors
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Recommendations
Increase OH&S awareness program through
OH&S sustainable training and information for all
stake holders.
Introduce and strengthen OH&S policy, practices
and practices which will employ a hierarchy if
control for all the companies in Uganda.
Include OH&S programs in the curriculum at
tertiary and higher institutions of learning.
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Recommendations
Develop and enforce a safety and health inspection
and management system in all companies and
institutions.
Immediate reporting of occurrences to enforce
authorities for investigation to avoid re-occurrence
Develop a H&S management system which will
provide employees with a safe and healthful place of
employment and identify hazardous conditions
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Recommendations
Employ a method of hazard control with in the
operation that is both technically and economically
feasible.
Establish a professional body of OH&S to co-ordinate
training and research in OH&S.
Have a long term program of OH&S awareness and
capacity building so as to instill and sustain a culture
of OH&S in industries in Uganda.
Avail and promote the use of PPE
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OCCUPATIONAL HAZARDS IN
AGRICULTURE
Margaret K.Semakula

11/5/2014

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Presentation Outline
Introduction and Definitions

Impacts of Agricultural hazards

Types of Hazards and their effects
Determinants of health and injury outcomes among
agricultural workers
Control of agricultural hazards
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Introduction:
Agriculture is one of the oldest occupations of mankind
and it is still the most dangerous or hazardous.
Agriculture sector employs 50% of the world labour
force

About 1.3 billion workers employed

Agricultural workers are exposed to many harmful agent
and hazards
Routes of exposure include; inhalation, ingestion and
skin absorption
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Introduction II
2 to 5 million people every year suffer from acute
poisonings related to pesticide use and that 40,000 die.
Millions of injuries are known to occur, with at least
170,000 of these being fatal for agricultural.
Agriculture is divided into two broad sectors i.e. Crop
husbandry and animal husbandry

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Definitions:
Agriculture:- all forms of activities connected with
growing, harvesting and primary processing of all types
of crops with the breeding, raising and caring for
animals and with tending to gardens and nurseries(ILO)

Agriculture worker: Any person engaged either in

permanently or temporary, irrespective of his legal
status, in activities related to agriculture(ILO)

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Impacts of Agricultural Hazards:

Increased health care cost
Premature ageing
Absenteeism

Decreased productivity
Miscarriages

Congenital malformations
Morbidity and mortality
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Hazards:
Most hazards cross cut both sectors
Agricultural work possesses several characteristics that are risky for
health:
Exposure to the weather, close contact with animals and plants,
extensive use of chemical and biological products, difficult working
postures and lengthy hours, and use of hazardous agricultural tools
and machinery.
Hazards are categorised in to physical, chemical , biological and
psycho-social
Physical; -Cuts(machinery,plants,animal kicks); -Snake bites and
stings; Body pains and fractures; Heat stress, noise
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Physical Hazards
Musculo-skeletal disorders: Physical hazards can lead to
musculoskeletal disorders
The common disorders include low back injuries, sprains,
strains, neck and shoulder pains and arthritis of knees
and upper limbs
Activities associated with musculoskeletal disorders are;
heavy lifting, forward bending, bent-over position,
kneeling and excessive fast placed work
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Physical hazards
Heat stress: Heat stress is another important physical agricultural
hazards
Heat Stress occurs when the body builds up more heat than it can
handle

High temperatures, high humidity, sunlight and heavy workloads

increases the likelihood of heat stress
Improved ventilation and shade whenever possible should be
encouraged
Drinking plenty of water before, during and after work should be
encouraged
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Physical hazards
Agricultural Noise:
-Agricultural noise is another common health hazard on
the farm
-Noise-induced hearing loss has been found to affect a
quarter of younger farmers and at least 50% of older
farmers in the US

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Psycho-social hazards
Psycho-social hazards in agriculture may arise as a result
of;
-Depression
-Poverty
-Seasonal changes
-Agricultural losses
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Chemical hazards:
Pesticides and fertilisers can be dangerous if you are
working in fields that have been treated or sprayed with
them or when handling and applying them
Exposure to these substances can occur via the
skin,mouth,nose

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How to minimise exposure to pesticides

Following directions and signs about keeping out of
restricted areas.
Washing before eating, drinking, smoking,or using the
toilet.
Wearing proper work clothes that protect the body from
chemical residues.
Showering after work and putting on clean clothes.
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How to minimise exposure to pesticides II

Washing work clothes separately from other clothing
The employer should ensure that each worker wears and uses PPE
correctly and consistently
Use of Material Safety Data Sheets(MSDS)
Document from the manufacturer
Accompany the materials,
Chemical composition
Expiry dates
Safety measures while using
Clinical information in case of spillage and Overdose
Antidote etc
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Agricultural machinery
Hazards associated with driving tractors include;
-Roll-overs
-Run overs
-Collisions
-Exposure to moving machinery

-Hazardous weather conditions

-Uneven landscapes
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Prevention of Hazards due to Machinery

Tractors should be equipped with roll-over protective
structures (ROPS) and seat belts. Operators should be
required to wear the seat belts.
No riders should be permitted on tractors, machinery or
other vehicles, unless a safe seat for riding is provided.
All agricultural workers should be provided with safety
training BEFORE being assigned a task and on a regular
basis thereafter. While this is important for all
employees, it is critical for those in the lower-skilled,
lower-paid occupations.
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Prevention of Accidents:
Responsible safety supervision should be provided for
all employees; it is critical for inexperienced employees.
Inspections of work areas and work tasks should be
undertaken to identify unsafe conditions and practices.
Immediate corrective action should be taken.

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Biological hazards:
Exposure to infective and parasitic agents
There are three categories A,B, and C.
In all the three categories, there are;
-Viral
-Bacterial
-Parasitic diseases
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Biological Hazards II
Category A:
-Viral-tick borne encephalitis
-Bacterial-anthrax, brucellosis, tetanus, T.B
-Parasitic-hookworm, Schstosomiasis
Category B:
-Viral-rabies, mosquitoe encephalitis, Rickettsia-scrub
typhus

-Bacterial-Plaque, T.B
-Parasitic- Hydatid disease, malaria
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Biological hazards
Category C:
-Viral-tick borne fever, cow pox, foot and mouth disease
-Parasitic-Filariasis, trypanasomiasis, fungal-actinomycosis,
Histoplasmosis

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Skin Disorders and Cancers:

Skin disorders and Cancer are some of the most
important hazards in agricultural sector
Skin Disorders: Contact dermatitis is a skin disorder that
occurs among agricultural workers
There are two general categories;
-Irritant and allergic

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Skin Disorder II
Irritants act directly on the skin at the place of contact
Allergic sensitizers, however cause changes in the
immune system so that subsequent contact produces a
reaction.
Other types of agricultural dermatitis include; heat
rash, insect and plant irritants

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Cancers:
In agriculture, skin cancers can arise due to the long
hours workers spend exposed to sunlight
About 90% of all skin cancers occur on uncovered parts
of the body e.g. back of the neck. This problem is more
pronounced in non-black workers
There are three major types of skin cancer
-basal cell carcinoma, squamous cell carcinoma and
malignant melanoma
Basal cell carcinoma is the most common form
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Determinants of health and injury outcomes

among agricultural workers:
Type of farming activity: Fatalities are common in
mechanised farming while injuries are more common in less
mechanised areas.
Type of worker.- skilled or unskilled, spraying, planting etc
Geographical location e.g. although developing countries
accounted for only 20% pesticide use in the 1990s,they
contributed to 99% of poisoning because of rudimentary
conditions.
Form of animal husbandry; different animals suffer from
different diseases
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Control of agricultural hazards:

Engineering controls-equipment and design
Administrative controls
-Empowering workers so that they have a say in determining
working conditions e.g. Unions
-Enforcement of existing regulations and codes of conduct e.g.
ILO and WHO guidelines for reducing hazards in agricultural
work
-Providing occupational health services to agriculture workers
-Intersectoral collaboration between health and agricultural
sector
Use of personal protective equipment like gloves,facemasks,gum
boots, overalls
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References:
William

Becker
and
Tracy
A.
Wood
UniversityofFlorida.
analysis of Agricultural Accidents in Florida for 1991

Understanding the links between agriculture and health

for food, agriculture, and the environment occupational
health hazards of agriculture. Donald cole , 2006

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Occupational hazards among health

care workers
Margaret K. Semakula

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Presentation outline
Introduction - definitions

Aetiology
Public Health significance
Ugandan situation
Control of occupational hazards among health workers
Observations
References
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Introduction definitions
Occupation is that which occupies or engages the time
and attention; the principal business of ones life;
vocation; employment; calling; trade.
It is also the act or process of occupying or taking
possession; actual possession and control; the state of
being occupied; holding or keeping; tenure; use; as the
occupant of lands by tenant
An Occupational hazard is any exposure that may pose
a substantial threat or potential danger to human health at
the workplace when not properly handled. It may be
carcinogenic, toxic, corrosive, irritant, mutagenic,
3 teratogenic.
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Introduction definitions
Worker means any person who performs services in exchange
for remuneration, other than a person who performs services as
an independent contractor
S/he is also an apprentice who is engaged primarily for purpose
of receiving training in a trade or profession
(The Workers Compensation Act, 2000)
Service industry is where services other than tangible objects or
goods are provided (Hyperdictionary 2000-2003, Webnox Corp)
like in health sector
Health sector is specialized arm of govt and other players that
provides health services through a range of providers eg doctors
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Introduction definitions
Accident: Is an unanticipated, sudden event that may
cause an undesired outcome such as property damage,
bodily injury, or death
Injury: Is physical damage to body tissues caused by an
accident or by exposure to environmental stressors e.g. a
heavy object falling and crushing bones in a workers
foot

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Aetiology
A host of occupational health problems are found in
the service industry especially related to the nature of
work environment
Most of these problems go unrecognized or uncompensable because most of this work is informal
and off record
Can be overt or concealed, affecting health workers
who deliver health services thru carcinogenic,
toxic, corrosive, irritant, mutagenic, teratogenic
effects
Factors that cause occupational health hazards can be
physical, chemical, biological and ergonomic

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Aetiology
Among health workers there is a great range of workplace

hazards like airborne infections, blood borne infections,

workplace assault, ergonomic hazards and work Stress
Biological hazards:
caused by living organism
Pose a threat to health workers

Organisms include viruses, bacteria, fungi, parasites

Risk of acquiring HIV in the work place is 0.5% to 0.7% due to
puncture with contaminated needles, etc
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Risk of acquiring hepatitis Margaret

B is 3 times that of HIV
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Aetiology
Chemical hazards

Play an important in hospital services since health

personnel can absorb them when they manipulate them or
get near them
Include anaesthetic gases, antiseptics, cytotoxic reagents,
drugs and other pharmaceuticals
Induce physio-pathological effects on the worker
depending on the concentration, manipulation, exposure,
susceptibility, agent and protective measures adopted

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Routes can be through inhalation, absorption, ingestion

May produce allergens, irritations, systematic poisoning,
etc
May be acute or chronic
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Aetiology
Physical work hazards
Include ionizing radiation (X-rays and other radio-active
elements from radiology), radiotherapy tablets, car
accidents, etc
Lead to organ damage, infertility and possible cancer
Noise exposure is common in dentists and orthopeadic
surgeons noise induced hearing loss, stress and loss of
concentration
Temperature and electricity related to autoclaves, theatre
lamps, boilers and other electric appliances may lead to
health stroke, heat rash, stress and heat exhaustion
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Aetiology
Ergonomic work hazards:
Ergonomics is the application of human biological sciences
in conjunction with engineering sciences to achieve the
optimum mutual adjustment of man and his work, the
benefits being measured in terms of human efficiency and
wellbeing (ILO)

Ergonomic hazards in health service are manifested in

weariness and injuries due to overloads or incorrect
positions in conduct of the work
Examples of stressful actions include lifting patients
nurses can present with high rates of back aches,
neurological symptoms and pain due to strain
Ergonomic stresses lead to tenosynovitis, bursitis, carpal
tunnel syndrome and muscle strain
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Aetiology VI
Psychosocial work hazards

May be present due to physical work environment work stress, coping psychology, work safety climate,
work load

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Possible outcomes of work stress

Physiological
Short term: ed catecholamines, ed cortisol and ed
blood pressure
Long term: Hypertension, Heart disease, ulcers and
asthma

Psychological

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Short term: Anxiety, dissatisfaction, pyschogenic illnesses

Long term: Depression, Margaret
burn out & mental disorders
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Outcomes of work stress

Behavioural

Short term: Job absenteeism, decreased friendship libido, decreased participation, alcoholism, drug abuse
and smoking
Long term: learned helplessness

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Public Health significance

Occupational related diseases & ill-health are an important
cause of morbidity and mortality in the world
Lead to epidemics with high severity
Viral hepatitis B infection is a major cause of morbidity
and mortality
Related costs high vaccinations, medications, time,
human capital

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Uganda situation - example

Ebola in Gulu, Uganda had a Case Fatality Rate of
52.71% (224/425) (Okware et al., 2002)
Vaccination against hepatitis B among health workers
initiated at Mulago National Referral Hospital through
external support

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Uganda situation -Observations

Occupational hazards among health workers is a recognized
public health problem worldwide and in Uganda especially
among health professionals
However, generally relatively little attention is paid to
occupational health hazard due to:

False perception that the industry is self regulated

Industry employing females must be a safe industry
focus on curative rather than preventive
Lack of attention to health and safety by the responsible
agencies

There is need for well established surveillance systems so as

to generate information to inform control interventions
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Steps to control occupational hazards

First, identify the problem through: discussions, surveys,
collect objective data, analyze data
Secondly, design and implement interventions: target
areas for change, propose and prioritize interventions,
communicate plans, implement interventions
Thirdly monitor and evaluate interventions

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Hazard control strategies I

Build general awareness about work related problems

Get management commitment in support of preventive

measures
Get employee input and involvement in the program
Have technical capacity to conduct the program
Engineering changes
Administrative changes
Personal protective equipment
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Hazard control
Biological

Maintenance through clean ventilation systems

House keeping
Universal precautions (like decontamination,
cleaning, sterilization)
Personal protective devices/wear (gloves and masks)
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Hazard control III

Chemical

Use lower toxic materials, especially for anaesthetics and

other aerosols
Engineer for lower emissions and radiations
Reduce exposure times and introduce better procedures and
make use of personal protective equipment like gloves, face
masks, gowns, face shields
May do remote operations or manipulations in scheduled
chambers
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Hazard control IV
Physical

Includes acoustic engineering, isolation of vibrations,

remote operations, use earplugs, shielding like lead
shields in X-ray rooms, skin and eye protection
goggles
Also includes modifying work-rest schedules,
drinking fluids as well as wearing clothing that allows
better heat loss
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Hazard control V
Ergonomic
Equipment design (key boards, operating theatres) can
be used to anticipate ergonomic hazards so that the
tolls are more user friendly
Workstation design is important: patients need to be
rolled on trolley, with adequately slanting walk-ways
There is also need for work-rest scheduling
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Alternatively in summary..

HAZARD.
CONTROL.
1. Biologic.
a) Viral hepatitis, HIV. Safer needle devices,
hepatitis B vaccine.
b) TB.
Isolate patients, UV light,
respirators.
c) Hypersensitivity Non latex gloves and
from latex gloves.
supplies.
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Alternatively in summary..
HAZARD.
2 Chemical
a) Ethylene oxide
b) Antineoplasic
drugs
c) Waste anaesthetic
gases
d) Mercury

CONTROL.
Aeration of rooms
Class I isolation hoods
Isolate off gassing pt. &
scavenging systems
Use electronic
thermometers
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Alternatively in summary..
HAZARD.
3. Physical
a) Back pain and
Injury
b) Musculo-skeletal
pain fm static posture
c) Ionising radiation
d) Physical assault
e) Lasers

CONTROL.
Pt handling devices,
lifting teams, training
Rest, breaks, exercise,
support shoes
Shielding
Alarm systems, security,
training
Face shield, local
exhaust ventilation
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Alternatively in summary..
HAZARD.
n
4. Psychosocial/Org
a) Violence, threats/
physical assault
b) Restructuring
d) Work stress
e) Shift work
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CONTROL.
Training
Employee involvement
Stress prevention and Mx
program
Table and predictable
shift rotation
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References I

Hyperdictionary 2000-2003, Webnox Corp

Marjolein Dieleman, Vincent Bwete, Everd Maniple, Mirjam
Bakker, Grace Namaganda, John Odaga and Gert Jan van der Wilt
(2007) I believe that the staff have reduced their closeness to
patients': an exploratory study on the impact of HIV/AIDS on
staff in four rural hospitals in Uganda
http://www.biomedcentral.com/content/pdf/1472-6963-7-205.pdf
(accessed o 10 Oct 2008)
MFL Occupational Health Centre 102-275 Broadway Winnipeg,
MB R3C 4M6 949-0811
http://www.mflohc.mb.ca/fact_sheets_folder/hospital_hazards_revi
sed.pdf (accessed on 10 Oct 2008)
The workers compensation Act, 2000
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