OCCUPATIONAL OCCUPATIONAL HEALTHHEALTH NURSING NURSING

INTRODUCTIONINTRODUCTION

WHAT ISWHAT IS WORK & HEALTH WORK & HEALTH

WORKWORK / / OCCUPATIONOCCUPATIONAn essential human activity that occupy a An essential human activity that occupy a

considerable part of a person’s waking hoursconsiderable part of a person’s waking hoursCan be stimulating & rewardingCan be stimulating & rewardingCan contributeCan contribute to to stress stress

HEALTH HEALTH NOT merely the absence of disease BUT a state NOT merely the absence of disease BUT a state

of complete physical, mental, social and spiritual of complete physical, mental, social and spiritual well-beingwell-being

(Wellers, 2000)(Wellers, 2000)

What is Occupational What is Occupational HealthHealth??

WHO defined Occupational Health asWHO defined Occupational Health as;;

‘‘the promotion and maintenance of the highest the promotion and maintenance of the highest degree of physical, mental and social well-being degree of physical, mental and social well-being of workers in all occupations’of workers in all occupations’

(Harrington & (Harrington & Gill,1992)Gill,1992)

Cont......Cont......

Concerned with two-way relationship of Concerned with two-way relationship of WORKWORK and and HEALTHHEALTHRelated to the effects of working conditionRelated to the effects of working condition andand//or or environment on health of worker – environment on health of worker – influence on ability to perform tasks in the influence on ability to perform tasks in the workplaceworkplacePrevention is better than cure –ensuring Prevention is better than cure –ensuring work & working condition DO NOT affect work & working condition DO NOT affect the health of peoplethe health of people

What is Occupational Health What is Occupational Health Nursing?Nursing?

Application of nursing principles in conserving Application of nursing principles in conserving the health of workers at the workplace.the health of workers at the workplace.

Based on principles ofBased on principles of recognition, recognition, prevention prevention and and treatment of illness, injuries. treatment of illness, injuries.

Formally known as Formally known as ‘Industrial Nursing’‘Industrial Nursing’

Pioneers of OHN ServicesPioneers of OHN Services

Florence Nightingle (UK 1820)Florence Nightingle (UK 1820)

Phillipa Flowerday (UK 1878)Phillipa Flowerday (UK 1878)

Betty Moulder (US 1888)Betty Moulder (US 1888)

Ada Mayo Stewart (US 1895)Ada Mayo Stewart (US 1895)

Aims of OHNAims of OHN Promotion and maintenance of the highest Promotion and maintenance of the highest

degree of physical,mental and social well-being degree of physical,mental and social well-being of workers in all occupations ;of workers in all occupations ;- by preventing- departures from health caused by preventing- departures from health caused

by their working conditions,by their working conditions,- protecting the workers in their employment -protecting the workers in their employment -

from risks resulting from factors adverse to from risks resulting from factors adverse to

health health - and adaptation of work to the workers and and adaptation of work to the workers and

workers to their jobsworkers to their jobs

ObjectivesObjectives

Maintenance and promotion of workers’ Maintenance and promotion of workers’

health and working capacity(health and working capacity(Health Health

monitoringmonitoring))

Improvement of working environment and Improvement of working environment and

work to become conducive to safety and work to become conducive to safety and

health(health(Worksite visitsWorksite visits))

Development of work organisations and Development of work organisations and

working cultures in a direction, which supports working cultures in a direction, which supports

health and safety at work(health and safety at work(Health EducationHealth Education ) )

Relevant Legislations on Occupational Health & Relevant Legislations on Occupational Health & SafetySafety

• Employment Order 2009Employment Order 2009( pre-employment medical ( pre-employment medical examinations ,first aid & medical treatment, worker examinations ,first aid & medical treatment, worker housing ,night work ,child labour)-housing ,night work ,child labour)-Previously Brunei Previously Brunei Labour Laws 1954 Labour Laws 1954

• Workmen Compensation Act 1957 Workmen Compensation Act 1957 (workplace (workplace accidents & occupational diseases)accidents & occupational diseases)

• Workplace Safety & Health Order 2009 Workplace Safety & Health Order 2009   

The Scope of OHN practice The Scope of OHN practice

1.1. Prevention of Prevention of ooccupational injuriesccupational injuries

2.2. Prevention of Prevention of ooccupational illnessccupational illness

3.3. Reducing work place hazardsReducing work place hazards

4.4. Promotion of worker’s healthPromotion of worker’s health

5.5. Restoration of worker’s health (maintenance of Restoration of worker’s health (maintenance of

worker’s health)worker’s health)

Occupational injurOccupational injuriesies

such as a cut, fracture, such as a cut, fracture, sprain, amputation, etc, sprain, amputation, etc, thatthat may may results from a results from a single instantaneous single instantaneous exposure or incident in exposure or incident in the work departmentthe work department or or during the course of during the course of work.work.

Occupational illnessOccupational illness

any abnormal condition or disorder, other than one any abnormal condition or disorder, other than one resulting from an occupational injury caused by resulting from an occupational injury caused by exposure to environmental factors associated with exposure to environmental factors associated with employmentemployment..

It canIt can be be acute or chronic illnesses, acute or chronic illnesses, following following exposure to the hazards throughexposure to the hazards through inhalation, inhalation, absorption, ingestion, or direct contact.absorption, ingestion, or direct contact.

Work and HealthWork and Health

Exposure to health hazards in the workplace Exposure to health hazards in the workplace may cause adverse health effectsmay cause adverse health effects

Disease development depends onDisease development depends on;;

host factors, non-occupational exposure host factors, non-occupational exposure ((lifestyles lifestyles & hobbies)& hobbies), , environmentalenvironmental factors, factors, inherent properties of the agent, exposure inherent properties of the agent, exposure level, exposure lengthlevel, exposure length & & other workplace other workplace stressorstressors.s.

Factors influencing our HealthFactors influencing our Health

Genes• Determine who you are

• Likelihood of contracting disease

Lifestyles• Smoking

• Diet

• Alcohol

• Stress

• Exercise

Environment•Workplace

• Leisure

• Domestic/living Environment

Health

Cause and effectsCause and effects

Cause iseasy to see

Cause ishard to see

Minutes Days Months Years Decades

Accidents

Welder’s Flash

Solventeffects

Fume fevers

Musculo-skeletal disorders

Dermatitis

Stress

NIHL

Mesothelioma

Lung cancer

Leukaemia

Basic Principles of Disease PreventionBasic Principles of Disease Prevention

High degree

of hazardTERTIARY

PREVENTION

System of enquiry

SECONDARY PREVENTION

Limited evidence of hazard and exposure

PRIMARY PREVENTION

Higher level of surveillance

Lower level of surveillance

NURSING INTERVENTIONS

• Treatment / Referral• Lung Function Test• Personal Protective Equipment

• Health Screening• Early detection

• Health education• Base-line health assessment• Elimination of substances

WWorkplace Hazardsorkplace Hazards

Physical hazardsPhysical hazards

Chemical hazardsChemical hazards

Biological hazardsBiological hazards

Mechanical hazardsMechanical hazards

Psychosocial hazardsPsychosocial hazards

Ergonomic HazardsErgonomic Hazards

SafetySafety

Workplace Health & SafetyWorkplace Health & Safety

Who are legally responsible for identifyingWho are legally responsible for identifyingand correcting health and safety hazards?and correcting health and safety hazards?

Authorised personnelsAuthorised personnelsEmployers Employers ContractorsContractorsOwnersOwnersWorkersWorkersSupervisorsSupervisorsSelf-employers personsSelf-employers personsSuppliersSuppliers

Protected workers fundamental Protected workers fundamental rightsrights

To know about hazards in the workplace, how To know about hazards in the workplace, how to identify them and how to protect themselvesto identify them and how to protect themselves

To participate in health and safety decisions To participate in health and safety decisions through management’s consultation with through management’s consultation with occupational health committees and workersoccupational health committees and workers

To refuse unusually dangerous workTo refuse unusually dangerous work

According to According to The Occupational Health The Occupational Health and Safety Actand Safety Act - OSHA - OSHA (1993) (1993),,

“…“…..everyone in the workplace is..everyone in the workplace is required required

to work together to identify andto work together to identify and controlcontrol

health and safety hazards”health and safety hazards”

Who are the Occupational Health Who are the Occupational Health Team?Team?

Occupational health Occupational health physicianphysician

Occupational health Occupational health nursenurse

Occupational health Occupational health epidemiologistepidemiologist

Occupational Occupational hygienisthygienist

Industrial toxicologistIndustrial toxicologist

Industrial psychologistIndustrial psychologist

ErgonomistErgonomist

Occupational Occupational therapisttherapist

PhysiotherapistPhysiotherapist

Health educatorHealth educator

Safety engineerSafety engineer

THANK YOU !THANK YOU !

ErgonomistErgonomist

design the workplace and the job to fit the design the workplace and the job to fit the worker. worker.

It deals with designing and changing the It deals with designing and changing the workplace to ensure employees are not workplace to ensure employees are not injured or made unusually uncomfortable injured or made unusually uncomfortable when working.when working.

ErgonomicsErgonomics

Lifting and handling loadsLifting and handling loads

Work that involves standing for long periods of Work that involves standing for long periods of time, antifatigue mats and footreststime, antifatigue mats and footrests

Situations where it is appropriate for workers to Situations where it is appropriate for workers to be permitted to sit while working, seating be permitted to sit while working, seating requirements and footrestrequirements and footrest

Musculoskeletal injuries which include muscle Musculoskeletal injuries which include muscle injuries or disorders of tendons, ligaments, injuries or disorders of tendons, ligaments, nerves, joints, bones, etcnerves, joints, bones, etc

EpidemiologistEpidemiologist

studies the incidence and distribution of studies the incidence and distribution of diseases in large populations, and the diseases in large populations, and the conditions influencing the spread and conditions influencing the spread and severity of disease. severity of disease.

HygienistHygienist

responsible for responsible for recognizing, evaluating recognizing, evaluating and controlling health and controlling health hazards in the workplace.hazards in the workplace.

to do this an occupational to do this an occupational hygienist will examine the hygienist will examine the work environment and work environment and work activities. work activities.