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Occupational Health & Safety

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Learning Objectives

Lead Poisoning

Sources

Symptoms

Prevention & Control

Occupational Health Services

MCQs & SAQs

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Paint

Petrol

Pencils

Pottery

Plates (Lead plates used in batteries)

Pipes (lead pipes)

Polish (leather polishing)

Printing industry

Pesticides

9 Ps of Sources of Lead

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A Anaemia

B Bartonian lines

C Colic abdominal, constipation, convulsions, coma

D Drop (foot/wrist drop), delirium

E Encephalopathy

ABC of Lead Poisoning

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F Fatigue

G GIT symptoms (anorexia and dysphagia)

H Headache, hyper uricaemia, Haemolysis

I Insomnia / irritability

J Judgment decreased

K Kidney function impaired

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L Loss of appetite

M Mental confusion and memory loss

N Nausea, vomiting diarrhoea

P Palsy (Paralysis) / pains in extremities

R Red cell stippling / Renal failure (acute)

T Telekys sign / tremors / teratogenic effects

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Advantages of Occupational health care

Investigates and assesses load factors and hazards andgives expert assistance for eliminating them

Gives information and advice

Estimates employees working ability and monitors

their health conditionBy 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 productivitycontinued

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Prevents occupational diseases and other work-related illnesses

Prevents premature incapacity for work, reduces

pension costs

Reduces absenteeism due to sicknessCan make calculations of the profitability ofoccupational safety and health and occupational

health care in cooperation with workplaces or

encourage workplaces to make these themselves.

Advantages of Occupational health care

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Assessment of dusts pollution

Assessment of noise pollution

Assessment of vibration

Assessment heat radiation

Assessment of radiation

Components occupational health

servicesCONT..

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Occupational epidemiology

The science of the occurrence of diseases inhuman population as applied to the field ofoccupational health for the following

purpose:- Identification of diseases of occupational origin

when the same diseases also occur in thecommunity at large.

Identification of causes of occupational, disease Checking the effectiveness of control measures

through prospective studies.

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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 Standards11

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HIERARCHY OF CONTROLS

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OCCUPATIONAL HEALTH SURVIELLANCE PROGRAMME

Remedial Action Plan

Remedial action Plan should state the Additional control andrecovery 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 andtarget dates for actions.

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PRE -EMPLOYEMENT HEALTH SCREENING

To determine the pre-existing health conditions of individuals prior tocommencement of work

To make sure that he / she is physically and mentally fit for the type ofactivity he / she is employed for.

At the time of employment , HR/ IR arrange pre-employment medicalexamination in liaison with Medical Dept.

General physical Examination

Chest x-ray

ECG

Urine R/E

Stool R/E Hepatitis B Ag

Anti HCV Antibodies

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Specialized tests will be conducted for staffdeputed on specialized jobs or they have special

requirements as part of their job like crane orfork lift operators , drives, Electrical Technicians

Color blindness

Audiometric tests

Pre employment Medical Record will bemaintained in personal file of individual byMedical Dept. at HO

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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.

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Functions of Occupational Health Service

1. Placing people in suitable work2. Maintaining people in suitable work

3. Providing treatment

4. Controlling recognized hazards

5. Identifying unrecognized hazards

6. Avoiding potential risks

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7. Screening for early evidence of non-

occupational disease

8. Health education and safety training

9. Surveillance of sanitary, catering & welfare

amenities

10.Environment control outside the work place

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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.

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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

Legislative Measures

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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

Social Security Act (PESSI-1965)

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Occupational Hygiene Inspection

What are you going to inspect???

- Refer to the checklist on factory inspection

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Silicosis: X-ray chest shows Snow-storm appearanceAnthracosis: Small, ill-defined opacities in the mid &upper zones

Asbestosis: Ground-glass appearance in lower twothirds of lung fields

Byssinosis: Monday morning fever (Tightness in thechest )

Farmers Lung: Due to exposure to grain

Special Characteristics

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Expected Questions

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MCQ-1

A person aged 40, who had been working as alabourer in grain market for the last 25 yearspresented with history of repeated attacks ofrespiratory infections in the last 1 year. X-ray

showed pulmonary fibrosis. The likely diagnosiswas:

a. Tuberculosis

b. Sillicosis

c. Sillicotuberculosis

d. Farmers lung

e. Baggassosis

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MCQ-2

A Ship Breaking Industry worker reported toyou with complaints of cough, dyspnoea onexertion and chest pain. His X-ray chestshowed Honeycomb appearance. The

diagnosis would be:a. Asbestosis

b. Siderosis

c. Silicosisd. Aspergillosis

e. Byssinossis

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MCQ-3

A worker who had been in the batterymanufacturing unit for the last 20 years, reportedto you with complaints of lost appetite andabdominal colic of 2 weeks duration. You would

prefer to investigate him for:a. Cholecystitis

b. Lead poisoning

c. Appendicitis

d. Ameobiasis

e. Stomach cancer

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MCQ-4

A woman working in an industry during nightshifts is exposed to 750 lux of light. She is

most probably at risk of:

a. Keratomalaciab. Breast cancer

c. Dermatitis

d. Conjunctival xerosise. Night blindness

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MCQ-5

Which of the following disease is morecommon in rural areas in the agriculturists

who are mainly dependent on farming in the

fields?a. Chronic bronchitis

b. Lung Cancer

c. Zoonotic diseasesd. Drug dependence

e. Acute Respiratory Tract Infections

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MCQ-6

Air pollution can lead to which one of the

following :

a. Bronchial asthma

b. Impetigo

c. Chronic bronchitis

d. Cholecyctitis

e. Lumbago

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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

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MCQ-8

X-ray chest shows ground glass appearance in

lower two-thirds of lung in:

a. Anthracosis

b. Silicosis

c. Asbestosis

d. Farmers lung

e. Bagassosis

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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 particlese. Siderosis is due to inhalation of sugarcane fibres

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MCQ-10

Which of the following is responsible for over

half of all deaths from unintentional injuries?

a. Drowning

b. Motor vehicle crashesc. Poisoning

d. Firearm injuries

e. Air Crashes

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MCQ-11

Majority of the mortality by road traffic

accidents can be saved by:

a. Seat belts

b. Safety helmets

c. Leather clothing

d. Goggles

e. New Tyres

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MCQ-12

A farmer of rural Punjab reports to a medicalofficer in the month of August with thecomplaints of fever, severe head-ache, anorexia,weakness, prostration, arthralgia, weakness and

rash. The doctor noticed petechiae and bloodexamination shows leucopenia. The probablediagnosis is:-a. Malaria

b. Classic dengue fever

c. Typhoid

d. Chicken pox

e. Meningococcal meningitis

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MCQ-13

Bagassosis is due to inhalation of :-

a. Sugar cane fibers

b. Sand particles

c. Cotton fibers dust

d. Tobacco particles

e. Sand particles

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MCQ-14

The headquarter of ILO is in:

a. Geneva

b. Rome

c. Paris

d. New York

e. London

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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

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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?

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h i i l l h? h ill

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What is Occupational Health? What steps you willtake for prevention of occupational diseases?

What are sources of lead poisoning? Write signs andsymptoms caused by it. Give preventive measures.

Define pneumoconiosis. What are common dusts

causing pneumoconiosis? Give detailed account ofsilicosis.

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?

Th k !!

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Thank you !!