1overview of ohs in cmc. dr. reginald g alex

OVERVIEW OF OCCUPATIONAL HEALTH IN CMC AN UPDATE Reginald G Alex

Occupational Health – CMC Vellore 1

SCOPE OF THE PRESENTATION

Introduction

Hazards in Hospitals

OHS

OH team and activities in CMC


FOOD FOR THOUGHT !

By the seventh day God had finished the work He had been doing; so on the seventh day He rested from all His work

Genesis 2:2


FOOD FOR THOUGHT !

Define “WORKAHOLIC” !!


24hr Working Society

No workplace is HAZARD free

Adverse Health Effects

Sick Workforce Absenteeism Prolonged illness Poor performance

Poor safety

Substandard / Poor productivity

Occupational / Work Related

THE RATIONALE

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HAZARDS IN HOSPITAL

Physical

Dust and Occupational Asthma

Occupational Dermatitis

Radiation

Noise

Temperature

Eye injuries

Chemicals including anesthetic gases

Biological hazards including animal bites

Ergonomical hazards including man-machine handling, poor posture

Psychosocial hazards including workplace stress


WHY IS OH NEGLECTED IN HOSPITALS?

Considered as low risk group

Lack of awareness

Lack of priority

Lack of scientific evidence

Priority to certain hazards

Priority to certain groups

Part time / Contract workers


Premedical Checkup &

Vaccination

OCCUPATIONAL HEALTH SERVICE

Selection

Health Promotion

Hazards

Physical

Chemical

Biological

Ergonomical

Psychosocial

Surveillance

Health Protection

Biological Environmental

Clinical Non-Clinical

Periodic check up Sickness

Absenteeism

Persistent absence / ill

health

Appropriate guidelines for

control

Evaluation

Hazard Identification

RISK ASSESSMENT

Appropriate guidelines for

control

Reporting & Documentation Periodic Evaluation

Education Programs

Promotion Programs and Policies

Information/ Counseling Centers

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CHRISTIAN MEDICAL COLLEGE located in Tamil Nadu in the southern part of India in a district called Vellore.

Out patient : 6000 and In patient : 2500

Working staff : 8809 (doctors, nurses and support staff )

Students : 1462 (health science and allied health science students)

Employees are the asset of an organization and they needs to be protected.


INITIATIVE TAKEN BY CMC

One year training in National University of Singapore on Occupational Health


POST TRAINING INITIATIVES

Need Assessment

Staff awareness training on occupational hazards

Hazards identification in specific areas

Small studies carried out


SAMPLE STUDIES


VISUAL AND MUSCULOSKELETAL ERGONOMICS STUDIES

Visual and musculoskeletal ergonomics among professionals using microscope in a tertiary care hospital in South India


61.3% of people using microscope had at least 1 eye symptom

59.7% had neck pain

66.1% had back pain

Occurrence of eye symptoms and strain increase with increase in working hours on microscope

Occurrence of musculoskeletal symptoms increase with increase in working years on microscope

STUDIES ON NECK PAIN AMONG HEALTH CARE WORKERS

• Prevalence and risk factors for neck pain among Health Care Workers


The prevalence of neck pain among support staff in this tertiary care hospital was 36.9%

Women and those with a BMI of more than 25 were found to have a higher risk for developing neck pain.

A lack of job control, bad posture and repetitive movements were also found to be risk factors for developing neck pain.

ASSOCIATION BETWEEN SHIFT WORK AND METABOLIC SYNDROME STUDY

The Association Between Rotating Shift Work And Metabolic Syndrome Among Hospital Employees


The prevalence of metabolic syndrome among the hospital employees studied in CMC, Vellore was 33.1%

No significant statistical difference between the two groups for the prevalence of metabolic syndrome after adjusting for other confounding factors.

DISEASE PROFILE & OUTCOME OF CMC STAFF /STUDENT ATTENDING THE ED

Total number studied – 1129

73.39% of people belong to the age group 16 – 35

68.92% are female

33.16%) of the cases reporting to ED are GI illness/ Fever

An alarming 16.83% cases are trauma cases


EMERGENCE OF THE OH TEAM

Formation of Occupational Health Team under the HR directorate - 2013.

The core committee


Chairman Associate Director, HR

Convener Occupational Health officer

Members

Medical superintendent Nursing superintendent

General superintendent Dean (CON) or nominee

Deputy Director (Quality) Radiation Officer

Head SSHS Audit facilitation officer

Safety officer Head – Staff & training

Head Personnel

OCCUPATIONAL HEALTH TEAM


SUB-COMMITTEE


Physical

Dust and occupational Asthma Dr. Barney issac

Dermatology Dr. Dincy Peter

Radiology Dr. Rabbi Raja singh, Dr. Livingstone, Dr. Deva Kumar

Noise Dr. Anajali Lepcha, Ms. Jessi Sharma, Mr. Arul Prakash

Temperature/ Electrical,/Electromagnetic Mr. Eswaran

Vision Problem Dr. Padma Paul

Chemical

Lab Dr. Joe Fleming, Dr. Asha, Dr. Vijay Kumar

OP/Ward/Theatre Ms. Florence Ponnie, Ms. Margret

Biological

SSHS Dr. Henry

HICC Dr. Hema

Ergonomics Dr. Judy, Mr. Leny

Psychosocial Dr. Anju Kuruvilla

OBJECTIVE OF THE TEAM

Identifying potential Occupational Hazards or risk

Appropriate preventive strategies

Hazard communication to the employees

Educating employees regarding Occupational Hazards

Conduct frequent audits and checks to ensure compliance

Documentation of the health hazards and occupational diseases

Follow up


APPROACH OF THE TEAM

Specific hazards group formation

Hazard Mapping

Periodic Meetings

Preventive strategies

Implementation of preventive measures

Education on safety practices

Periodic monitoring

Reporting and documentation


HAZARD MAPPING


HAZARD MAP OF CMC VELLORE


POTENTIAL HAZARDOUS AREA IN CMC


RADIATION RISK ZONES Main Block R ward, Dept. of Radio diagnosis

Main Block Cardiology, Cath lab

Main Block Main OR

ISSCC Block CB OR

RT Block Basement1 and Basement 2

HIGH TEMPERATURE RISK ZONES Main Block Laundry

Main Block CSSD

Main Block Main OR and TSSU

Engineering Block Boiler Section

NOISE RISK ZONES Main Block Laundry

Main Block CSSD

Engineering Block Boiler Section

Engineering Block Generator room

Engineering Block Dietary

HAZARD MONITORING AND REPORTING


NOISE HAZARD

High Risk Areas identified - CSSD, Laundry and Boiler section

Measurement of Noise level

Audiogram testing of the Respective staff

Personnel Protective Equipment's were provided

Education on safe practices


Noise level MEASUREMENT in BOILER, LAUNDRY & CSSD

Noise levels were measured for 3 days on 3 different timings and on difference locations with the help on an Audio Technician from ENT department

Noise levels were found to be very high in Boiler, high in Laundry and CSSD Main source of noise were found to be the Equipment

Boiler Laundry CSSD


AWARENESS PROGRAM Classes were conducted for Boiler Section Staff & CSSD

Classes will be combined with Mandatory Training in future for all other CMC staff

SIGNAGE’S & POSTERS


SIGNAGE AND POSTERS


NOISE RISK MITIGATION • Audiogram

Baseline audiogram tests for all staff in vulnerable areas

Extend this test to all CMC staff & new all comers

Include this test in Annual Medical Checkup

• RECOMMEND PROTECTIVE DEVICES & CONTROLS


Hearing protectors

Ear Muffs

Ear Plugs

Administrative controls

Decreasing the exposure time

Limiting the number of personnel

exposed

Engineering controls (costly)

Enclosure

Sound barriers

Sound proof cabs

Mufflers

Equipment and exhaust

RADIATION HAZARD MITIGATION

Personal monitoring devices

Radiation safety accessories

Radiation safety survey in diagnostic rooms

Regular radiation dose monitoring of staff in cath labs

Training modules on radiation safety

Radiation safety awareness programs


RADIATION HAZARD MITIGATION


ERGONOMICAL HAZARD

“Back school” with Physiotherapist, Occupational Therapist, Staff Clinic

Physician and Physiatrist started in 2010

Awareness workshop on Point prevalence of Pain, Workstation design

and Exercises for WRMSDs

Audits on Musculoskeletal health of staff

Warm up exercises for staff in the department


ERGONOMIC RISK MITIGATION


CHEMICAL HAZARD


CHEMICAL HAZARD Audit on Hazardous Chemical Spill (Mercury)

Phasing out Mercury containing devices

World Day for Safety and Health at Work 28.04.2015

Sensitization of Staff on Occupational Hazards related to chemicals

Hazmat Safety (e.g. Acid Safety)

Chemical Spill Clean-up Protocol e.g. Mercury

Significance of MSDS and their availability in their work place in our hospital

Future Plan:

HIRA Mapping of Chemical Hazards


CHEMICAL HAZARD MITIGATION


Dr. Joe Fleming addressing the gathering Mrs. Florence Ponnie explaining access to MSDS

BIOLOGICAL HAZARD

Segregation protocol in place

Training at all levels

Labeling of bags

Audit and feed back

Construction of Temporary storage area

Usage of PPE while handling waste

Monthly review meetings

Periodic site visit


STUDY OF COMPLIANCE ON WASTE SEGREGATION


PSYCHOSOCIAL HAZARD

Increasing awareness on identification of and consequences of

stress in the workplace

Increasing awareness on methods of dealing with stress

including life style modification, environmental modification,

meditation, yoga, regular exercise.

Providing a help-line and dedicated counsellors

Providing confidential and effective redressal processes.


PERIODIC MEETINGS


OTHER ACTIVITIES

In the 1st National Conference on Safety held on January 2014,

one of the component was focused on Occupational Health

Occupational Health Day was celebrated on 28th of April 2015

and the Occupational Health logo was released which was

designed by one medical student and one nurse.

The 1st National Conference on Occupational Health is going to

held on 30th and 31st of October 2015


OH DAY CELEBRATION – APRIL 28TH, 2015


OCCUPATIONAL HEALTH IN CMC LOGO


ACADEMIC ACTIVITIES

Introduction of Occupational Health subject in MBBS, MPhil,

Occupational Therapy, Physiotherapy and nursing curriculum

Seminars on importance of occupational health and hazards

Factory visits

Research activities by MBBS, PG and Nursing students


THE ROAD AHEAD

Strengthening of the team

Creating modules

Improving staff awareness and education through CMEs and

Quality circle

Improving monitoring system

Proper reporting system

Policy making


THANK YOU


1overview of ohs in cmc. dr. reginald g alex

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