Download - Medical Surveilance Workshop 2010 04 16
Occupational HEALTH
The Occupational Health Timeline
BC: Hypocrates describes the symptoms of lead poisoning, not realising it is an occupational disease1700: Ramazinni, the “Father of occupational health” says the patient must always be asked what their occupation is.1833: The first factory inspectors and medical examinations in occupational health conducted in England.1895: The first occupational disease is declared notifiable.1980: South Africa starts training doctors and nurses in OH1993: The OHS Act is published as well as compensation legislation1996: The Mine Health and Safety Act is published
OH Timeline (cont)
South African health care professionals only received training from 1980!
Mining (open diamond mining) already started in 1872, gold mines in 1887.Farmers have been using pesiticides for decades prior.Factories have been using chemicals and operated in high noise levels long before 1980.Construction sites have been operating for even longer, full of dust and noise.The fishing industry have been operating for centuries before 1980.
➢ The industries have been in existence long before occupational health care in South Africa.
OH Timeline (cont)
According to a study conducted and published in the SASHON Journal of 2009, occupational disease in South Africa is made up of the following:
NIHL – 56%Depression/PTHD – 13%Dermatitis – 12%TB – 5%Pneumoconiosis – 4%Occupational asthma – 3%
This brings us to today's topic:
Medical Surveilance
Hazard identification
Risk assesment
Risk mitigation
Medical serveilance
Medical Surveilance
Medical surveilance according to OHS Act:
A planned programme or periodical examinations of employees by an OHP or
OMP (in prescribed cases).
Medical Surveilance
Periodical examinations may include:
Clinical examination
Biological monitoring
Medical tests
Medical Surveilance
Clinical examinations:Examining the body
Biological monitoring:Collecting body fluid, tissue or exhaled air to detect of quantify the exposure or absorption of any substance or organism by a person.
Medical tests:X-raysAudiometrySpecial vision screening
Steps toward Medical Surveilance
Hazard identification
Risk assesment
Risk mitigation
Medical surveilance
Hazard Identification
Physical Hazards
Chemical hazard
Biological hazards
Ergonomical hazards
Psycho-social hazards
Physical Hazards
Noise NIHL
Vibration Raynoud's Phenomenon (vibration white fingers)Osteo Arthritis (hand arm vibration)Lower back pain (whole body vibration)Early degeneration of lumber spine (whole body vibration)
Physical Hazards (cont)
Electricity
Burns
Electrocution (death)
Electrification (shock)
Physical Hazards (cont)
Extreme temperatures
Heat Stroke
Frostbite
Radiation
Cancer
Physical Hazards (cont)
Dust
Pneumoconiosis (inorganic dust)
Silicosis
Asbestosis
Occupational Asthma
Chemical Hazards
Solvents
Benzene – Leukemia
Toluene – NIHL (Noise & Toluene)
Etc.
Chemical Hazards (cont)
Metals
Metal fume fever
Pesticides
Organophosphate poisoning (lethal)
Chemical Asphyxiants
Carbon monoxide (coma, lethal)
Biological Hazards
Snake/Spider bites (loss of limb, lethal)
HIV
TB
Ergonomical Hazards
Illumination (glare, headaches, poor vision)
Repetitive actions (repetitive strain disorders,
poor work performance, pain, pain, pain!)
Psycho-social Hazards
Stress
High-blood pressure
Stroke
Depression
Psycho-social Hazards (cont)
Boredom
Stress
Depression
Psycho-social Hazards (cont)
Substance abuse
Injuries
Death
Lung disease
Psycho-social Hazards (cont)
Night Work
Stress
Social issues
Metabolic disorders (i.e. Diabetes), due to biological clock
disturbances (controlled metabolic illnesses can become
uncontrolled)
Risk Assessment
Using a measuring tool, ranking the hazards as low, med and high.
Risk matrix
Risk rating sheet
Basic risk scale
One might need:
Occupational hygienist
Material safety data sheets
Risk Mitigation
Reducing the effect of the hazard on the employee's health
Engineering controls (ex. Less noisy machines)
Adminstrative controls (shift rotation, less personel in area, rules
and regulations)
Personal protective equipment (gloves, safety specs, etc)
AND THEN:
Medical Surveilance
Plan the examinations and the intervals or frequency. Medical
surveilance will only change if the process or the environment
changes.
Frost Bite
Heat Stroke
Sunburn
Skin Cancer
Electrocution
Electrical Burns
Raynoud's Phenomenon
Spider bites
Stroke
Metal Fume
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