Occupational Health

Hazards and
Workers’ Health

Marissa G. Lomuntad - San Jose, MD, MOH

Supervising Occupational Health Officer

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 Occupational Health
(ILO / WHO)
“ The promotion and maintenance of the
highest degree of physical, mental and social
well-being of workers in all occupations by…

PLACING worker in
PREVENTING PROTECTING tasks adapted to
workers from workers from his ability.”
getting sick, health risks, 2
 Health Hazards
Physical Agents
noise, vibration,
radiation,
defective illumination,
temperature extremes

Chemical Agents
Biological Agents dusts, gases, vapors,
viruses, bacteria, fungi, fumes, mists, etc.
parasites, insects, etc.

Lack of Ergonomic Principles

exhaustive physical exertions, excessive
standing, improper motions, lifting heavy
load, job monotony, etc.
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 Factors that Determine
Disease Development

Workplace Factors Individual Factors

Duration of Exposure Age

Concentration of Agent
Health Habits
Route of Exposure
Reproductive Status
Workplace and Personal Hygiene

Control Measures in place Medical History

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 4
Solving Occupational Health
Problems
Identify Hazards

Evaluate Hazards

Prioritize Problems

Select Intervention

Implement Intervention
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER 5
PHYSICAL HAZARDS
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER

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NOISE
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER

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  Hearing Loss
Acute noise-induced
Noise


damage: exposure to high

Health Effects intensity sound stimuli such
as explosions
 Temporary Hearing Loss
 Decrease in the sensitivity of
auditory sensory cells
 In early stages, is reversible
 Permanent Hearing Loss
 Exposure to high-intensity
sound over several years
 Involves frequency to which
the ear is sensitive, 4000 Hz

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 8
 Noise: Effects on General
Health

dilation of pupils
muscle reaction

constriction of
blood vessels secretion of
thyroid hormones
palpitation

secretion of
adrenalin
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER 9
VIBRATION
Department of Labor and Employment
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  Health Effects
Vibration  General stressor

Whole Body
Vibration

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 11
  Health Effects
Vibration  Fatigue of leg muscles
 Chronic venous
Whole Body
insufficiency (veins
Vibration
cannot pump enough
blood back to the heart)

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 12
HEAT STRESS
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER

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 Heat Stress

Department of Labor and Employment

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 Heat Stress
MAIN CLINICAL
DISORDERS CAUSES PROGNOSIS
FEATURES
Prickly heat Malfunction of Pruritic rash Good
sweat glands
Heat cramps Loss of water and Cramps in limbs Complete recovery
electrolytes
Heat exhaustion Physical exertion, Dizziness, blurring Complete recovery
loss of water & of vision with cold usual
electrolytes and clammy skin
Heat stroke Failure of Convulsions, High mortality;
temperature control muscle twitch, Sequelae: poor
center in brain delirium with hot memory &
and dry skin; Temp concentration,
> 41°C headache

Department of Labor and Employment

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RADIATION
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER

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 Radiation: Non-Ionizing
Radiation Sources Effects
Optical radiation: Sunlight, Welding Arc flash erythema,
ultraviolet rays skin cancer, sunburn

Electromagnetic Radio communications, Vertigo, nausea

field satellite / radar links

Department of Labor and Employment

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CHEMICAL HAZARDS
Department of Labor and Employment
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Chemical  Chemicals are either
Hazards naturally occurring or
man-made.
General
Concepts  They have a wide
range of possible
health effects.

Department of Labor and Employment

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Chemical  Chemicals are found
Hazards everywhere around
us….
General
Concepts

Department of Labor and Employment

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Chemical  …. in food we eat
Hazards
General
Concepts

Department of Labor and Employment

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Chemical …. in the water we drink
Hazards
General
Concepts

Department of Labor and Employment

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Chemical …. in consumer
Hazards products we use
General
Concepts

Department of Labor and Employment

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Chemical …. and the air we
Hazards breathe
General
Concepts

Department of Labor and Employment

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Chemical
Hazards
General “All substances are
Concepts poisons – only the
dose
separates a
poison from a remedy…”

Paracelsus

Department of Labor and Employment

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Chemical
Hazards
General
Concepts

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 26
Chemical
Hazards
General
Concepts

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 27
Chemical  Usually involves skin,
Hazards eyes, and lungs
ALLERGIC
REACTION

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 Chemical Hazards
Undesired Effects

IMMEDIATE DELAYED
 Occur rapidly after  Occur after the lapse
single dose of some time

Department of Labor and Employment

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 Chemical Hazards
Undesired Effects

REVERSIBLE IRREVERSIBLE
 Affected tissues are  Affected tissues not
able to regenerate able to regenerate
 Liver  Injury to the CNS
 Cancer

Department of Labor and Employment

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 Chemical Hazards
Undesired Effects

LOCAL SYSTEMIC
 Occur at site of first  Require absorption and
contact distribution of a toxic
 Ingestion of caustic substance from its
substances entry point to a distant
 Inhalation of irritant site at which harmful
materials effects are produced.
 Almost all chemicals

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 31
Chemical
Hazards
Health effects

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 32
Chemical
Hazards
Individual A chemical
Susceptibility may affect
one person
differently
than another.

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 33
Chemical
Hazards
Routes of Entry

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 34
Chemical
Hazards
Routes of Entry

absorption
inhalation

ingestion

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 35
Chemical  Chemicals may be
Hazards absorbed through
healthy skin into the
Absorption
bloodstream and
carried to different
parts of the body
where they can have
damaging results.

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 36
Chemical  They can enter the
Hazards eyes as vapors or as a
splash of liquid.
Eye Splash

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 37
Chemical  Broken glass, needles
Hazards or even airless spray
guns could inject
Injection chemicals into your
system.

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 38
Chemical  Hazardous substances
Hazards may be swallowed
unknowingly by
Ingestion workers

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 39
Chemical  The lungs is a major
Hazards route of entry of
chemicals
Inhalation

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 40
DUSTS
Department of Labor and Employment
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Chemical Hazards
Dusts

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 42
Chemical Hazards
Dusts: asbestos (pipe insulator)

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 43
Chemical  Significant
Hazards contribution of
occupational
Global Burden
exposures
of Occupational
Lung Diseases  About 13 percent of all
(WHO, 2002) chronic obstructive
pulmonary disease
(COPD)

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 44
Chemical  Burden of asbestos-
Hazards related diseases still
rising even in
Global
countries that have
Burden of banned the use of
Occupational
asbestos in the early
Lung Diseases
(WHO, 2006) 1990s
 long latency periods

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 45
  5 to 10% of lung cancers
Chemical
may be attributed to
Hazards
occupational exposures
Situation  Of the more than 100,000
chemicals in the
workplace, 13 agents and
mixtures are established
respiratory carcinogens.
 There are more than 34 M
Filipino workers

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 46
 Chemical Hazards
 Prolonged and Lung Cancer
chronic exposure to
asbestos fibers
increases the risk
of developing lung
cancer
 Tobacco smoke
exacerbates the risk

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 47
 Chemical Hazards
Scarring of Lung from Silica, Asbestos and Coal
COAL MINERS’
SILICOSIS ASBESTOSIS PNEUMOCONIOSIS NORMAL

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 48
 Medical Surveillance
 Pre-employment
 Medical history and P.E.
 Baseline blood levels of
chemicals or their
metabolites
 Periodic examination
 Same as pre-
employment

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 49
BIOLOGICAL HAZARDS
Department of Labor and Employment
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Biological  soil
Hazards  insects
Sources  plants
 birds
 animals, and
 humans.

Department of Labor and Employment

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Biological
Hazards
Tuberculosis

Department of Labor and Employment

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Biological  Alternative name
Hazards  TB; tuberculosis –
pulmonary
Tuberculosis
 Definition
 A contagious bacterial
infection caused by
Mycobacterium
tuberculosis.

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 53
Biological
Hazards
Tuberculosis

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 54
Biological  Inhalation of droplets
Hazards sprayed into the air
from a cough or
Tuberculosis
sneeze by someone
infected

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 55
Biological
Hazards
Tuberculosis:
General
Symptoms

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 56
Biological
Hazards
Tuberculosis:
Prevention

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 57
HUMAN IMMUNODEFICIENCY
VIRUS (HIV)
Department of Labor and Employment
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HIV and AIDS
H - Human
Definition I - Immunodeficiency
V - Virus (HIV)

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 59
HIV and AIDS
A - Acquired
Definition I - Immunodeficiency
D - Deficiency
S - Syndrome

Department of Labor and Employment

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HIV and AIDS  chronic and fatal illness
Definition which affects the body’s
immune system making
it unable to combat
infection.

Department of Labor and Employment

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HIV / AIDS  To be transmitted, HIV must
enter the bloodstream of
Transmission another person in large
enough quantities to infect
them
 Virus is present in:
 Blood
 Semen
 Vaginal fluids
 Breast milk

Department of Labor and Employment

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  During unprotected
HIV / AIDS sex
 Through blood
Route of Entry
transfusion and blood
products
 From an HIV (+) mother
to her baby

Department of Labor and Employment

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 HEPATITIS B
Department of Labor and Employment
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  Hepatitis B is caused
Hepatitis B by a virus that infects
the liver
Why Should
Filipinos Be  It is considered as the
Aware of silent Asian epidemic
Hepatitis B?  Most do not even know
they are infected

Department of Labor and Employment

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  Hepatitis means
Hepatitis B inflammation of the
liver
What is hepatitis
B?  It can be caused by
viruses, drugs and
toxins
 There are many
different types of
viruses that can cause
hepatitis
 Hepatitis A, B, C, D, E,
and G
Department of Labor and Employment
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  Mother to child (during
Hepatitis B pregnancy or
childbirth)
How is Hepatitis
 Majority of Filipinos
B transmitted?
become infected at
birth or as young
children
 Sexual contact
 Exposure to
contaminated blood or
body fluids (semen,
vaginal secretions, etc)
Department of Labor and Employment
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ERGONOMIC
STRESSES
Department of Labor and Employment
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Ergonomics
Definition “Ergonomics is the
science of fitting jobs
to the people
who work in them”

- OSHA

Department of Labor and Employment

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  to reduce work-related
Ergonomics musculoskeletal
disorders (WMSDs)
Goal
developed by workers

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 70
  WMSDs are injuries
Ergonomics and illnesses that
affect muscles, nerves,
What are
tendons, ligaments,
WMSDs?
joints or spinal discs
that are shown or
suspected to have
been caused by
workplace activities.

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 71
 Common Symptoms of WMSDs
 Workers suffering from WMSDs may
experience:
 less strength for gripping or hand
grasping
 less range of motion
 loss of muscle function, and
 inability to do everyday tasks.

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 72
 Common Symptoms of
WMSDs
 Painful joints
 Pain, tingling, numbness in hands,
wrists, forearms, shoulders, knees and
feet
 Shooting or stubbing pains
 Swelling or inflammation

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 73
 Common Symptoms of
WMSDs
 Fingers or toes turning white
 Back or neck pain
 Stiffness

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 74
Ergonomics
Common
WMSDs

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 75
 Medical Surveillance
 Pre-employment
 Medical history
 Physical
examination

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 Medical Surveillance
 Annual medical
examination
 X-ray of affected
body part
 CT-scan of
affected body part
 Other appropriate
laboratory
examinations

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OCCUPATIONAL HEALTH
PROGRAM
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER
• c

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Rule 1960: Occupational Health Services

 Health Programs shall include:

 Entrance
 Periodic
 Special examination
 Transfer examination
 Separation examination

Department of Labor and Employment

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 Monitoring: Medical
Surveillance
 systematic monitoring of health events
 to prevent, detect and control
occupational hazards and their
associated diseases
 Entrance (Baseline) Examinations
 Periodic Screening (Specific, Job Related)
 Fitness for Duty (Specific Cause)
 Exit Examination
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER 80
 Why Do Medical
Surveillance?
1. Identify cases
 Early detection of job-related health problems
(2°)
 Determine their causes

2. Analyze Trends and Patterns in the

Workforce to Guide Prevention Efforts (1°)
 Supplement Environmental Monitoring to
Confirm the Effectiveness of Controls

3. Meet Regulatory Requirements

Department of Labor and Employment
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 DOLE Issuances
Title Scope Components
Department Order No. 53-03: Mandatory for A. Advocacy,
Guidelines for the Implementation of a companies with 10 or Information,
Drug-Free Workplace Policies and Programs more workers to Education and
include supply chain
for the Private Sector Training
Department Order No. 73-05: Guidelines for All workplaces in the B. Preventive
the Implementation of Policy and Program private sector Strategies
on Tuberculosis (TB) Prevention and Control including their C. Social Policy
in the Workplace supply chain D. Health Care
Services
Department Order No. 102-10: Guidelines E. Benefits and
for the Implementation of HIV and AIDS Compensation
Prevention and Control in the Workplace F. Monitoring
Program and
Enforcement
Department Advisory No. 05-10: Guidelines
for the Implementation of a Workplace
Policy and Program on Hepatitis B
 DOLE Issuances
Policy and Program TB HIV Hep B
Jointly developed by management and workers X X X
Mandatory; covers all workplaces X X X
Advocacy, Education and Training X X X
Preventive Strategies X X X
Medical Management (Diagnosis, Treatment, Referral) X X X

Social Policy (non-discrimination, work X X X

accommodation)
Roles and Responsibilities X X X
Employers
Workers
Safety and Health Committee
Government
 Health & Safety Programs

Hazards / Source Health Effect Health

Disease Program
Physical
Noise Cutting Hearing Hearing
machines Impairment Conservation
Program

Biological
Tuberculosis Co- Weight loss, TB Prevention
workers fever, cough Program

Department of Labor and Employment

OCCUPATIONAL SAFETY AND HEALTH CENTER 84
 Health & Safety Programs
Hazards / Health Health
Source
Disease Effect Program
Ergonomic
Stresses  Awkward Muscle and  Management or
WMSDs postures bone disorders personnel
 Heavy methods
loads  Workplace
modification
 Worker
education and
training
 Back Care
Program
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER
 THANK YOU!
Department of Labor and Employment
OCCUPATIONAL SAFETY AND HEALTH CENTER