topic no.1 occupationa health
DESCRIPTION
DOSHTRANSCRIPT
1
Occupational Health Overview
Diploma in Safety & Health Course Programme
Tay Kay Chuang
MSc.in OSH (USA)
Topic No. 1
2
Scope
1. Brief History of Occupational Health2. Definition of Occupational Health 3. Focus of Occupational Health 4. Various disciplines of Occupational Health5. Safety versus Health6. Health Hazards7. Concept of Prevention and Control
3
1. Occupational Health History
A. Ancient times, Middle Ages, and the Renaissance1. Ancient Times Miners of Ancient times (slaves, prisoners or criminals). Poor working conditions (almost a complete disregard for workers’ safety and health) in
gold, silver and lead mines of Ancient Greece and Egypt.2. Middle Ages Mining in Central Europe had become a skilled occupation. Intensified mining - mines got deeper and conditions worsened (Premature deaths of
workers mainly due to pulmonary diseases – silicosis + TB).3. RENAISSANCE Mining, metal work & other trades flourished in Italy. First systemic study of trade diseases by Bernardino Ramazzini, 1633-1714(Father of
Occupational Medicine) was based on visits to workshops.
4
1.Occupational Health History continued ..
B. Industrial Revolution in Great Britain Latter half of 18th Century, Mechanization transferred the making of textiles from
peoples’ homes to the new factories. Problems : Workers of all grades exposed to pressures of increasing productions
(physical & psychological hazards at work)
Effects of industrialisation on Community health Family life disrupted as men moved into new industrial areas leaving
families behind Situation encouraged alcoholism and prostitution Epidemics due to overcrowding in unsanitary conditions. Malnutrition (poverty and unemployment)
5
1. Occupational Health History continued ..
Effects of industrialisation on worker health
• Workers in factories were exposed to hazards of occupational disease (wide range of chemicals)
• Workers had to work excessively long hours.
• Untrained Workers had to handle new machinery equipped with poor safety devices – high incidence of injuries
6
First Factory Act– 1819 (UK)
The first Factory Act was passed in 1819. It was applied to textile mills and laid down hours of work and regulations covering education and hygiene and child labour. The Act was known thereafter as the Magna Carta of Childhood and marked the first protection of the children of the poor from toil, starvation and ignorance.
Examples:
1. Children below 18 :• Not allowed to work in textile mills after 8.30pm till 5.30am• Not allowed to work more than 12 hours in a day or 65 hours per
week2.Meals break – not < 1.5 hours3.Unlawful to employ children who did not complete their nineth year of education to work in any factory.4.Unlawful to let children < 11 years old to work in factory > 9 hrs/day or > 48 hours per week
1. Occupational Health History … …continued
7
1. Occupational Health History …continued
Influence from developments in Medicine
Agricola and Paracelcus (15th Century) Physicians who made their first observations on miners and their diseases
Bernardino Ramazzini (1633-1714) Father of Occupational Medicine who made first systemic study of trade
diseases based on visits to workshops and described the associated treatment and preventive measures.
He recommended that physicians should routinely enquire about a patient’s occupation.
Percivall Pot (1713-88) Drew attention to soot as a cause of scrotal cancer in chimney sweeps.
Charles Turner Thackrah (1795-1833) Published the first British work on occupational diseases.
8
Class Exercise No.1
1. In the Ancient times, why were prisoners, criminals and slaves being asked to work in mining metals?
2. Why was Dr. Ramazzini recommended that doctors when seeing sick workers should ask for their occupation?
3. What were the social impacts of Industrial Revolution in UK in the later half of 18th Century , when machines were widely used for textiles making?
9
2. Definition of Occupational Health
Promotion and maintenance of the highest degree of the physical, mental and social well-being of workers in all occupations;
Prevention from amongst workers of ill-health caused by their working conditions;
Protection of workers in their employment from risks resulting from factors adverse to health;
Placing and maintenance of workers in an occupational environment adapted to their physiological and psychological ability.
Aim – To adapt work to man and each man to his job.
ILO / WHO committee on Occupational Health
10
3. Focus of Occupational Health Promote and maintain workers’ optimal Health.
Physical fitness to work Mentally sound (work-life balance; cordial work relationship) Social health (happy family , good nutrition no social ills such as alcohol & drugs
abuse, prostitution) Prevention from illnesses or diseases arising from the workplace or work
processes. Anticipation, identification, evaluation, control and review of hazards/risks.
Improve quality of work environment and work processes to suit workers’ physiological and psychological capabilities . Improve work space and means of access for workers to maintain
equipment (preferably at design stage).
11
Focus of Occupational Health
…continued
Concept of Promotion and Prevention
Occupational Health DiseasesWorkplace Accidents
Factors relating to work
-Hazards
-Work environment
- Working methods
-Equipment, machinery etc
Healthy Lifestyle
-No Smoking
-No Alcohol and drug
-Hobbies that promote health
Prevention Promotion
12
Class Exercise No. 2
1. Give 3 examples each of adverse factors that may harm the well-being of workers in terms of
Physical health Mental health and Social health
13
4. Occupational Health Disciplines
Occupational Medicine Industrial Hygiene Occupational Toxicology Ergonomics Epidemiology Industrial Psychology
14
Occupational MedicineMedical specialty concerned with the promotion and maintenance of the physical and mental health of employees in occupational settings.
• assessment of workers’ health • linking working conditions and processes to workers’ health• assisting in managing the health, skills and working capacity of
the entire working population and • managing individual cases in the context of working ability and
production
Industrial hygienePreventive science devoted to anticipation, recognition, evaluation and control of health hazards at the place of work
ToxicologyStudy of chemical or physical agents that produce adverse responses in the biological systems with which they interact.
15
Ergonomics
It is a scientific approach of how to fit the task demands of the workplace to the employee who perform the task.
Epidemiology
The study of the distribution and determinants of health-related states in specified populations, and the application of this study to control of health problems. Distribution – refers to analysis by time, place, and classes of person affected. Determinants – all the physical, biological, social, cultural, and behavioural factors that influence health.
16
Recent trends in OH
Last 30 years incidence Occupational Diseases (OD) reduced methods to detect early OD monitoring of workers’ exposure to health risks allows early
detection of OD epidemiology establishes exposure & diseases Exposure standards develop
These are largely due to improvement in technology, safer and healthier work environment, positive work behaviour of workers and employers, and introduction of OSH legislation to protect the safety and health of people at work.
17
5. Relationship between Occupational Safety and Occupational Health
Safety prevention of accidents (risks from moving machinery,
fire and explosions, lightning, falling objects, sharp objects, acid burn, etc.)
Health Prevention of diseases (risks from chemical, physical,
biological, ergonomics & psychological agents)
18
Cause and Effect
CAUSE
EFFECT
SAFETY HEALTH
CAUSE
EFFECT
Heredity
Previous
Exposures
Time
Dose
Lifestyle
19
Causes and Effects
Musculo-Skeletal Disorders (MSD)
Dermatitis
StressMetal Fume fevers
NIHL
Mesothelioma
Leukaemia
Lung cancer
Accidents
SolventEffects
Welder’s Flash
Minutes Days Months Years Decades
Cause is
hard to see
Cause is
easy to see
20
Hazard and Risk
HAZARD
Potential of an agent to cause harm to health
RISK
Likelihood that an agent will cause harm to health in the actual circumstances of
exposure
RISK = HAZARD X EXPOSURE
21
Hazard v RiskHazard- The potential of a chemical to cause harm
to an individual The Hazard relates to the intrinsic
properties of the chemical (its physicochemical properties and health effects) to cause harm and will always be the same
Risk- The likelihood of harm to worker
occurring under the actual circumstances of exposure The Risk is totally dependant on the actual
exposure (Intensity or magnitude x duration x frequency) to the agent.
22
7. Health Hazard types
2 basic Categories Acute and ChronicAcute
An acute effect is caused by short period of exposure (e.g. in seconds or minutes) to high concentrations of a substance.
Example: The acute effect of carbon monoxide (CO) poisoning where a brief exposure to a high CO concentration causes asphyxiation.
23
Hazards Types
Chronic Effects Chronic or long-term effects are caused by
repeated or prolonged exposure (continuing day after day or week after week), typically involving relatively low levels of a substance.
Example: Silicosis (causing fibrosis of lungs) is due to prolonged exposure over a number of years to crystalline silica.
24
Classification of Health Hazards
1. Physical 2. Chemical 3. Biological 4. Ergonomic 5. Psychological
There are 5 general groups of Health Hazards
25
1.1. Physical HazardsPhysical Hazards
From NoiseFrom Noise
From LightFrom Light
Examples of the 5 Groups of Health Hazards
26
From Temperature Coldness
Heat stress
Vibration
Radiation
1.1. Physical Hazards:Physical Hazards:
27
From Welding Fume, Mineral oils, Paints,, Silica sand, Acids, Alkalis, Solvent (Thinner, Adhesive, Benzene, Diesel).
28
•Bacteria (e.g. E.Coli, Staphylococci,TB, legionella);•Virus(e.g. Hepatitis A,B & C, HIV, SARS, Avian Influenza);•Fungus & Spores
29
Manual lifting, Posture, Repetitive Movement, Space, Comfort.
30
ERGONOMIC HAZARDS
Air temperature too hot/cold, low relative humidity
Poor design, inaccessibility,insufficient space, awkward postures
Mismatch of work environment
WorkstationToo bright/dim
Manual lifting
31
Mental stress, Overwork, Work Pressure, Long Shift Hours / work Schedule-night duty, offshore duty roster, boredom, Unreasonable deadline ,cultural shock., poor communications, monotonous work
Increase risk of incident.
32
Routes of Entry of “Poisons” into human body
Inhalation- most significant route of entry (respiratory system)
Absorption (through skin, eye and mucous membrane)
Ingestion (mouth) Injection
33
8. Principles of Prevention and control Systematic approach
to control of hazards thorough
understanding of process required
Control hierarchy Closing the loop
Review
Anticipation
Identification/recognition
Assessment/Evaluation
Control
34
8. Principles of Prevention & Control1. Anticipation Predict or expect dangerous situations before they occur and take steps to prevent them.
2. Identification/Recognition Identify hazardous situations (worksite audit, incident investigation report, literature,
exposure monitoring) Understanding work process and materials used
3. Assessment/Evaluation Assess work process and risks involved Can be qualitative or quantitative assessment involving ther services of experts
4. Controls Implemented based on risks identified. Preferred methods
Hierarchy of control principle. Principle of ALARP
35
The hierarchy of controls is a list in preferential order of the means by which exposure to health hazards can be controlled Elimination Substitution (alternatives) Engineering (plant and equipment) Procedural Personal protective equipment
Hierarchy of controls
Effectiveness of Controls
The types of control vary in their effectiveness according to the control hierarchy:
Elimination Most Effective
Substitution
Engineering
Procedural
PPE Least Effective
Types of controls
Elimination and substitution Engineering (plant and equipment):
Equipment/processes designed to prevent or minimize release of the hazard
Examples: containment (enclosure), exhaust ventilation, waste treatment process
Types of controls Procedural:
Safe systems of work / Permit to work system
Record systems
Staff Instruction, Information & training
Supervision, Emergency arrangements
Personal Protective Equipment (PPE):
Respiratory & Skin Protection as a secondary line
of defence or as the only option
last line of defence – least effective
39
Definitions of ALARP ALARP = As Low As Reasonably Practicable.“ This means “ balancing the reduction in risk against : State of knowledge about the hazard or risk Availability and suitability of ways to remove or mitigate the hazard or risk; cost of removing or mitigating the hazard or risk ALARP level represents the point, objectively assessed
based on existing knowledge, at which the time, difficulty and cost of further reduction measures become unreasonably disproportional to the additional risk reduction obtained.
ALARP Definition
40
••
••
•
•
Risk toHealth
Tolerability level
Cost ofControl
ALARPLegal Liability Wasteful
ALARP
41
Principles of Prevention & Control
5. REVIEW
Regular review by management for continual improvement on safe work practice.
Examples: Workplace inspection or OSH Management System audit Review on the close-out status of follow-up actions on
inspections, audits or incident investigation reports. Review on effectiveness of control measures.
Class Exercise No. 3Identify 2 Health Hazards and their Harmful Effects at your Workplace or home
Hazard Source Route Harmful Effect
1. Physical
2. Chemical
3. Ergonomic
4. Biological
5. Psychological