INTRODUCTION TO OCCUPATIONAL HEALTH

Presented By

Dr. Abrar Elahi MalikMBBS, DOMS, DHA, MPH

Director Human Resource ManagementAkhtar Saeed Medical College, Lahore

The branch of science which deals with the health issues specifically related to the occupations & most commonly do not arise otherwise e.g. Asbestosis which occurs where asbestos is present

People working under the same roof 19 ormore personsWorking space per person 4X4 feetOne acre for 20 workersBUTIndustrialists employ people on daily basis tokeep the number less than 19

INDUSTRIAL WORKER

A work place where a person is gainfullyemployed.

◦ Self Employed (Shop keeper)◦ Through Employer (in a factory)

OCCUPATION

Prescribed occupational health hazards Notifiable occupational health hazards Compensatory occupational health hazards

to compensate for loss of body parts (hands, feet, fingers, eyesight, deafness etc)

Classification of Occupational Hazards

Health hazards related to occupation,observed in practice ;but yet to be certified as occupational Hazard

Prescribed occupational health hazards

Anthracosis,coal miners diseaseByssinosis,cotton fibres,textile indus.Baggasosis,sugarcane industrySilicosis ,mining, pottery ,sandblastingAsbestosisLead poisoningCancers due to exposure to radioactivity

Notifiable occupational health problems

Noise induced deafness Chopping of a body part (hands, feet, finger

amputation)

Compensatory occupational health hazards

Causative agent According to Physical Agents

◦ Pressure◦ Noise◦ Vibrations◦ Heat or Cold (Burns & Frost Bite)◦ Radioactivity ( Workers in Xray Plants)◦ Light

Classification of Health Hazards

Respiratory diseases Toxic hazards Accidents Zoonotic diseases Physical hazards

OCCUPATIONAL HAZARDSAgriculture Workers

Chemical Agents◦ Gases◦ Liquids◦ Solids

Biological Agents◦ Virus Health Hazards◦ Bacterial health Hazards◦ Fungi

CLASSIFICATION as per Causative Agents

Lung health hazards Skin health hazards Kidney health hazards Liver health hazards Intestinal health hazards Hearing health hazards Eye health hazards

Classification as per Body Parts

Have you ever diagnosed a case of byssinosis or bagassosis?

Can you differentiate between Ch. Bronchitis and the above two?

Either no work is being done which is not possible or there is no intersectoral communication

Status of Occupational Health in Punjab- An Overview

Labour DepartmentHealth DepartmentNGOs

Various Departments involved in Occupational health in Punjab

Punjab Employees Social Security Institutions (PESSI)

Punjab Social Security Health Management Company (PSSHMC)

Centre for Improvement of Working Conditions (CIWC)

Labour Inspectorate Medical Inspectorate (now abolished) Medical Inspector of Factories (MIF)

Labour Department

Maintaining & running hospitals & dispensaries

Supports employees for◦ Marriage◦ Hajj◦ Education◦ Pension◦ Other benefits

PESSI is doing marvelous work but Cater services to those who come to them.

PESSI

Never visit the work places Very poor record keeping- no data is

available to categorize or characterize the patients

Most of health hazard patients go to LGH as general patients without any reference from social security medical centres.

Where the fault lies?

How many MSc Occupational health and diplomas in industrial health employed in PESSI?

No specialized/ trained occupational health staff to diagnose and advise on occupational health hazards e.g.◦ Byssinosis◦ Silicosis◦ Bagassosis◦ Asbestosis◦ Ch. Bronchitis

Much improvement is required in this department

PESSI continued

Good material on Occupational Health No record keeping Not providing Health Services

Enviormental & biological monitoring should go together

Enviormental (sanitation ,water supply,general plant ,sufficient place, toilet ,ventilation ,lighting)

Biological (Nutrition,communicable diseases,mental health & family planning)

CIWC (centre for improvement of working conditions)

Environment sanitation Water supply General Plant Sufficient place Ventilation Lighting Protection against hazards Housing etc

Environment

Nutrition Communicable Diseases Mental Health Health Education Family Planning etc

BIOLOGICAL

Not doing anything worth mentioning except controlling child labour

Labour Inspectorate

Good field staff Rarely instruct workers on health issues EDO Health is ex officio Inspector of

Factories (MIF)- Just enters the factories and asks about the health of the workers, signs the health cards and collects the fee.

Medical Inspector of Factories

Medical Colleges producing doctors & paramedics for providing health care services

Teaching hospitals provide clinical services to workers & teaching and traning of occupational health care staff

Institute of Public Health Lahore producing health administrators and public health physicians (99% are alumni of IPH). Also trains them on occupational health issues

Health Department

NOSHA (National Occupational Health Association)

Lack of coordination & updated information on the issue

NGOs

Major Accident If a worker remains away from duty for 72

hours (>3 days)Minor Accident If a worker remains away from duty for less

than 72 hours (<3 days)Major accident can be

◦ Fatal◦ Non fatal

Disabling Non disabling

Definitions

15 million work hours are wasted out of which >50% were due to pulleys accidents

Could be avoided if pulleys or chain belts were covered properly

Very little budget is allocated for Occupational Health in Punjab which is presently about 1 crore only.

At least @Rs20 per worker-30 crore are required

Survey shows

Best setup in Sweden All accidents are immediately attended to

and Ambulance and medical care is promptly available.

Occupational health