Occupational Health & Safety

1. Occupational Health & Safety

2. Learning Objectives Lead Poisoning Sources Symptoms Prevention & Control Occupational Health Services MCQs & SAQs

3. 9 P’s of Sources of Lead • Paint • Petrol • Pencils • Pottery • Plates (Lead plates used in batteries) • Pipes (lead pipes) • Polish (leather polishing) • Printing industry • Pesticides

4. ABC of Lead Poisoning AAnaemia BBartonian lines CColic abdominal, constipation, convulsions, coma DDrop (foot/wrist drop), delirium EEncephalopathy

5. FFatigue • GGIT symptoms (anorexia and dysphagia) • HHeadache, hyper uricaemia, Haemolysis • IInsomnia / irritability • JJudgment decreased • KKidney function impaired

6. LLoss of appetite • MMental confusion and memory loss • NNausea, vomiting diarrhoea • PPalsy (Paralysis) / pains in extremities • RRed cell stippling / Renal failure (acute) • TTeleky’s sign / tremors / teratogenic effects

7. Advantages of Occupational health care • Investigates and assesses load factors and hazards and gives expert assistance for eliminating them • Gives information and advice • Estimates employees’ working ability and monitors their health condition • By its knowledge and skills supports action for maintaining working ability in the development of individuals, working environment and working community, in this way also affecting productivity continued

8. Advantages of Occupational health care • Prevents occupational diseases and other work-related illnesses • Prevents premature incapacity for work, reduces pension costs • Reduces absenteeism due to sickness • Can make calculations of the profitability of occupational safety and health and occupational health care in cooperation with workplaces or encourage workplaces to make these themselves.

9. Components occupational health services – CONT.. • Assessment of dusts pollution • Assessment of noise pollution • Assessment of vibration • Assessment heat radiation • Assessment of radiation

10. Occupational epidemiology • The science of the occurrence of diseases in human population as applied to the field of occupational health for the following purpose:- • Identification of diseases of occupational origin when the same diseases also occur in the community at large. • Identification of causes of occupational, disease • Checking the effectiveness of control measures through prospective studies.

11. Legislation regarding occupational health and safety in pakistan Mines Act 1923 Factories Act 1934 Ordinance 2001 Docks Labours Act 1934 Petroleum Rules 1937 Pakistan Hazardous Operations Rules 1963 Workman's Compensation act 1923 and Rules 1961 Provincial Employees social Security Regulations 1967 The Oil and Gas (safety in drilling and production) Regulations 1974 Hazardous Substances Rule 2003 OHSAS 18001 Standards

12. HIERARCHY OF CONTROLS

13. OCCUPATIONAL HEALTH SURVIELLANCE PROGRAMME Remedial Action Plan Remedial action Plan should state the Additional control and recovery measures. Remedial action plan should be SMART. S------Specific M-----Measurable A-----Achievable R-----Realistic T-----Time bound This plan should include priorities, responsible person and target dates for actions.

14. PRE -EMPLOYEMENT HEALTH SCREENING To determine the pre-existing health conditions of individuals prior to commencement of work To make sure that he / she is physically and mentally fit for the type of activity he / she is employed for. At the time of employment , HR/ IR arrange pre-employment medical examination in liaison with Medical Dept. General physical Examination Chest x-ray ECG Urine R/E Stool R/E Hepatitis B Ag Anti HCV Antibodies

15. Specialized tests will be conducted for staff deputed on specialized jobs or they have special requirements as part of their job like crane or fork lift operators , drives, Electrical Technicians • Color blindness • Audiometric tests • Pre employment Medical Record will be maintained in personal file of individual by Medical Dept. at HO

16. PREIODIC HEALTH SURVEILLIENCE • Periodic Health Surveillance to be conducted for staff: • At risk from workplace exposure • In compliance with regulatory requirement • To detect early, reversible health affects • Periodic Surveillance Record will be maintained at Field / Location level.

17. Functions of Occupational Health Service • Placing people in suitable work • Maintaining people in suitable work • Providing treatment • Controlling recognized hazards • Identifying unrecognized hazards • Avoiding potential risks

18. Screening for early evidence of non-occupational disease • Health education and safety training • Surveillance of sanitary, catering & welfare amenities • Environment control outside the work place

19. Main Responsibilities of a doctor Working in an Industry • Knowledge of the work environment • Medical examinations for general as well as occupationally health surveillance • Treatment services for illness and injury • Health education • Ability to access, prevalence studies.

20. Legislative Measures The Factories Act • The factories act covers the matters relating to Health, Safety & Welfare of the workers • Lighting, Ventilation & Temperature Standards • Hours of work day (not more than 48 hours per week & 9 hours per day) • Employment of young persons (< 14yrs) • Treatment of Waste & Effluent to render them safe

21. Social Security Act (PESSI-1965) • Applicable to factories employing 10 or more employees • Deduction from the employees (7% of the total wages) • Benefits to the employees • Medical • Sickness • Disablement • Maternity • Dependents Benefit

22. Occupational Hygiene Inspection • What are you going to inspect??? - Refer to the checklist on factory inspection

24. Silicosis: X-ray chest shows Snow-storm appearanceAnthracosis: Small, ill-defined opacities in the mid & upper zonesAsbestosis: Ground-glass appearance in lower two thirds of lung fieldsByssinosis: Monday morning fever (Tightness in the chest )Farmer’s Lung: Due to exposure to grain Special Characteristics

25. Expected Questions

26. MCQ-1 A person aged 40, who had been working as a labourer in grain market for the last 25 years presented with history of repeated attacks of respiratory infections in the last 1 year. X-ray showed pulmonary fibrosis. The likely diagnosis was: • Tuberculosis • Sillicosis • Sillicotuberculosis • Farmer’s lung • Baggassosis

27. MCQ-2 A Ship Breaking Industry worker reported to you with complaints of cough, dyspnoea on exertion and chest pain. His X-ray chest showed ‘Honeycomb’ appearance. The diagnosis would be: • Asbestosis • Siderosis • Silicosis • Aspergillosis • Byssinossis

28. MCQ-3 A worker who had been in the battery manufacturing unit for the last 20 years, reported to you with complaints of lost appetite and abdominal colic of 2 weeks duration. You would prefer to investigate him for: • Cholecystitis • Lead poisoning • Appendicitis • Ameobiasis • Stomach cancer

29. MCQ-4 A woman working in an industry during night shifts is exposed to 750 lux of light. She is most probably at risk of: • Keratomalacia • Breast cancer • Dermatitis • Conjunctival xerosis • Night blindness

30. MCQ-5 Which of the following disease is more common in rural areas in the agriculturists who are mainly dependent on farming in the fields? a. Chronic bronchitis b. Lung Cancer c. Zoonotic diseases d. Drug dependence e. Acute Respiratory Tract Infections

31. MCQ-6 Air pollution can lead to which one of the following : a. Bronchial asthma b. Impetigo c. Chronic bronchitis d. Cholecyctitis e. Lumbago

32. MCQ-7 The cancer seen in aniline industry or with aromatic amines is: a. Skin cancer b. Lung cancer c. Cancer bladder d. Cancer rectum e. Cancer kidney

33. MCQ-8 X-ray chest shows ground glass appearance in lower two-thirds of lung in: a. Anthracosis b. Silicosis c. Asbestosis d. Farmer’s lung e. Bagassosis

34. MCQ-9 For Pneumoconiosis following is true:- a. Byssinosis is due to inhalation of cotton fiber dust b. Anthracosis is due to inhalation of iron dust c. Bagassosis is due to inhalation of coal dust d. Silicosis is due to inhalation of sand particles e. Siderosis is due to inhalation of sugarcane fibres

35. MCQ-10 • Which of the following is responsible for over half of all deaths from unintentional injuries? a. Drowning b. Motor vehicle crashes c. Poisoning d. Firearm injuries e. Air Crashes

36. MCQ-11 Majority of the mortality by road traffic accidents can be saved by: • Seat belts • Safety helmets • Leather clothing • Goggles • New Tyres

37. MCQ-12 A farmer of rural Punjab reports to a medical officer in the month of August with the complaints of fever, severe head-ache, anorexia, weakness, prostration, arthralgia, weakness and rash. The doctor noticed petechiae and blood examination shows leucopenia. The probable diagnosis is:- • Malaria • Classic dengue fever • Typhoid • Chicken pox • Meningococcal meningitis

38. MCQ-13 Bagassosis is due to inhalation of :- • Sugar cane fibers • Sand particles • Cotton fibers dust • Tobacco particles • Sand particles

39. MCQ-14 • The headquarter of ILO is in: • Geneva • Rome • Paris • New York •  London

40. MCQ-15 Anthrax is a disease caused by: a. Inhalation of coal dust b. Inhalation of silica c. Inhalation of spores d. Inhalation of a virus e. Inhalation of iron dust

41. SAQ-1 • A forty year old pottery industry worker presented with complaints of fever and weight loss; he also complained about cough and blood stained sputum. X-ray confirmed fibrosis of lungs and hilar lymphadenopathy: • Which factor in this particular trade has lead to the development of this condition? • Which measures do you recommend for prevention of this condition?

42. What is Occupational Health? What steps you will take for prevention of occupational diseases? • What are sources of lead poisoning? Write signs and symptoms caused by it. Give preventive measures. • Define pneumoconiosis. What are common dusts causing pneumoconiosis? Give detailed account of silicosis. • Enlist occupational risks to health care providers. • Write functions of occupational health services. • What are various health hazards to a farmer working in the fields?

43. Thank you !!