PRIMARY HEALTH CARE

OCCUPATIONAL HEALTH
Occupational health has been defined in various ways:
 (a) Occupational health could be defined as the sum total of all activities and
programmes that are engaged upon with the aim of achieving, maintaining and
promoting the highest level of physical, mental and social wellbeing for all
categories of workers that engage in all kinds of works.
 (b) Occupational health can be referred to as the creation of a state of physical
and mental well-being within the occupational environment while taking into
consideration factors relating to the social and domestic life of individual.
 (c) Occupational health is also the provision of public healthcare for all people
gainfully employed. It takes into account the study of all factors influencing the
health of workers at their places of work as well as at home.
 (d) A joint ILO/WHO committee defines occupational health as “The promotion
and maintenance of the highest degree of physical, mental, and social well-being
of workers in all occupations.”
AIMS AND OBJECTIVES OF OCCUPATIONAL HEALTH
The aims and objectives of occupational health include:
 the promotion and maintenance of the highest degree of physical, mental, and
social well-being of workers in all occupations
 the prevention among workers of departures from health caused by working
conditions
 the protection of workers in their employment from risks resulting from factors
adverse to health.
 the planning and maintenance of workers in an occupational environment
adapted to his physiological equipment
 the adaptation of work to man and each man to his job
  to provide emergency care and prevention of injuries and illness on the job
 to offer adequate advice and rehabilitation services for workers who are injured
and for those with psychological problems
 to maintain accurate morbidity and mortality records of workers
 to generate awareness and create safety consciousness in the workers of various
cadres
 to create health facilities and services where they are easily accessible and
available
 to reduce the risk of injury and health impairment of workers arising from
exposures to hazards in working environments.
ADVANTAGES OF OCCUPATIONAL HEALTH AND SAFETY
The advantages of occupational health and safety programmes include:
 enactment of laws specifying payment to workers for industrial accidents or for
illness caused by the occupation
 helping workers to become enlightened about the protection of their rights and
that their duties are well defined and attended to.
 ensuring suitable job placement
 promoting better health and ensuring longer life
 lowering personal medical costs
 sustaining employee earnings
 ensuring greater job satisfaction
 contributing to prosperity of the community
 decreasing welfare costs and improving public relations.

ROLE OF OCCUPATIONAL HEALTH IN PHC

1. The participation and involvement of every individual in working places/factions
in all activities connected with promotion of health, safety and welfare of
workers. This can be achieved through health education.
 2. The participation in all effort connected with improvement of the workers and
their environment in which they live and work. This can be in form of collective
general clearing of homes and factories, disposal of industrial and domestic
waste and joint responsibility in the promotion of maintenance of social services
where of workers live and work.
3. Encouragement of workers and members of their families to be immunized
against diseases which are associated with their job.
4. Accessibility to health care deliveries to every workers and members of their
family. Home visit should be employ to access the health problem of the family.
SCOPE OF OCCUPATIONAL HEALTH
The scope of occupational health is divided into three:
 Occupational medicine
 Industrial hygiene and safety services
 Industrial welfare services.
OCCUPATIONAL MEDICINE
Occupational medicine is concerned with the curative treatment/services provided for
the workers. It includes:
(a) Health assessment, which include pre-employment, pre-placement and periodic
medical examination
(i) Pre – employment medical examination
Pre–employment medical examination should be carried out on all new employees to
provide a base line data and also ensure that the job is suitable for the individual state
of health. The health assessment in some cases may be through the confidential health
questionnaires while in other cases it may be through the use of real medical and
physical examinations.
The medical and laboratory investigations performed actually depend on the types of
organization and processes involved and hazards exposed to. Examples of these
investigations are chest x-ray for those whose work involve being in contact with dust,
visual acuity test for those who will be welding or examining specimen under
microscopes; stool test for food handlers in the canteen etc.
These tests will enable the occupational health unit determine whether an individual is
fit or not for a particular job.
(ii) Pre – placement medical examination
This type of examination can also be performed on a new employee but it is mostly
performed when an employee is changing from one job or unit to another in the
establishment. This may be as a result of injury or illness. The objective is to put him in
the area most suitable for his health and capability without further risk to his health.
(iii) Periodic medical examination
Periodic medical examination is carried out at regular intervals after the initial pre-
employment and pre-placement medical examinations. The medical examination could
be carried out weekly, monthly, quarterly, and annually in order to treat and prevent
the spread of diseases from affecting other vulnerable personnel in the workplace.
(b) Curative function which include treatment of occupational and non-occupational
diseases
This includes the treatment of occupational and non-occupational ailments of workers.
Sick workers are encouraged to report early, whether or not the illness is as a result of
the occupation or not. The treatment is to prevent degeneration and spread of the
ailment to other workers. The occupational health team should ensure the cooperation
of other relevant agencies to ensure optimum treatment and early rehabilitation.
(c) Family health services
The management should provide industrial clinic or hospital or retainership in order to
have a complete knowledge about the health history of workers and their social
problems. The treatment of dependants is important in that it prevents workers from
taking time off work to seek medical help for their family members outside the work
environment thereby resulting in decreased productivity.
(d) Promotion and rehabilitation in health services
Health promotion services are aimed at improving workers’ health, morals and
productivity as well as controlling health care costs. The services include: exercise and
fitness programmes, stress management, safety education and first aid, posters,
pamphlets, newsletters, journals, health seminar/workshop to educate workers.
Rehabilitation is aimed at restoring the patient to his fullest physical, mental, and social
capability. It must start immediately after the injury and restoration activities
commenced and gradually done in stages as dictated by the health and capability of the
patient. Restoration of physical, social and mental health of the patient is achieved
through the use of drugs, exercises, psychotherapy, speech therapy, walking etc.
INDUSTRIAL HYGIENE AND SAFETY SERVICES
Industrial hygiene and safety services are concerned with the environmental hygiene
and safety of the work place. It consists of:
(a) Raw materials sampling of toxicity as well as exploration
Hazardous or toxic materials can be recognized by studying various work processes and
working environments to identify potentially dangerous zone, for example:
 the nature of the raw or processing materials utilized by the industry
 the finished product and by-products (waste) involved
 the possible area or point of release or emission of hazardous agents in the
company
 the process of packaging and transportation of goods
 the kind of protective gadgets or personal clothing provided
 the posture and movement of the workers
 the amount of time given off for rest at work
(b) Storage and disposal of radioactive and industrial toxic wastes or substances
(c) Engineering control of plants, which involves mainly the redesigning of industrial
equipment, tools and work stations include:
 substituting of safety or less hazardous materials
 shielding or screening of workers against hazard
 isolation of dangerous machines
 redesigning of work processes and procedures
 protecting the workers by way of protective clothing and devices
 designing ventilating system to extracts or dilutes air borne contaminations
natural, and artificial ventilations
 preparing a work rest regime of job rotation in order to reduce workers’ stress
 exposure limits regulation.
(d) Evaluation/analysis of actual potential hazards or stress in the work place
These include:
 measuring the intensity or concentration of hazardous or toxic substances in the
factory
 limitation of the threshold limit value (tlv) exposure period of workers to hazards
in the work environment
 comparing the results of measured hazards against known standards or research
toxicological data
 ascertaining the human physiological effects upon workers from result of tests
provided by the medical team, for example; blood, and urine analysis, lung
function test etc.
INDUSTRIAL WELFARE SERVICES
Industrial welfare services are specially arranged for workers to benefit from at work
place. It includes:
(a) Hazard/risk allowances, overtime, or shift duty allowances for the workers
(b) Accommodation/housing services for workers: The management should provide
housing accommodation for workers, that is, either free or subsidized renting value or
loan with low interest rate can be granted to workers to build and live in their own
houses.
(c) Life and health insurance schemes
(d) Transport facilities for workers:
Buses can be provided to convey workers to and fro place of work. Interest free loan can
also be provided for workers to purchase their own vehicles.
(e) Subsidizing cafeteria or restaurant services in the work place:
Workers in large establishments should be provided with cafeteria or restaurant
services where their meals are prepared and served at appropriate times. The purpose
is to ensure that workers eat balanced and nutritive diets and time wasted to search for
food outside the premises is saved.
The provision of adequate running water is also desirable to ensure that the workers
observe enough personal hygiene. It is also expected that food should be subsidized to
assist workers financially.
(f) Educational facilities to children of employees:
The management should provide educational opportunities to workers, their
dependants or wards to ensure the workers’ comfort. Programmes such as in – service
training, seminars, workshops, conferences are possible areas where workers can
update their knowledge for challenges over emerging situations.
(g) Employee recreational facilities:
Recreational facilities such as table and lawn tennis, volley ball, basket ball, short put,
swimming etc should be provided in the work environment for workers to recreate
themselves. The purpose is to ensure that workers keep fit in order to prevent
debilitating diseases such as fatigue, heart attack, high blood pressure, stroke, diabetes
etc.
OCCUPATIONAL HEALTH IN NIGERIA
The medical examining board of Liverpool Infirmary was the first to start health services
in Nigeria in 1789 by giving health services to the European slave traders. The United
African Company (U.A.C.) known then as the Royal Niger Company around 1899 was the
first company to organize its own medical services even though it was mainly curative
and exclusively for the expatriates. After the abolition of slave trade, there was the
Royal Naval Patrol trade meant to enforce the abolition of slave trade and also protect
the British commercial interests in Nigeria. All the territories were administered by Lord
Lugard as the Commander-in-Chief of the armed forces of Nigeria. When many soldiers
started to die of malaria disease, a curative and preventive health service was
immediately established for health and welfare of soldiers and the colonial
administrators. The unit was assigned only to treating the members of armed forces
during World War II. This was how public health service started in Nigeria.
As regards industrialization evolution in Nigeria, statistics from environmental and
occupational unit of the Federal Ministry of Health indicated that rapid increase in
industrialization began after 1960 when oil was discovered and there was oil boom. This
attracted various oil companies and industrialists. Occupational health services were
also established for the workers. Since then, there has been steady awareness and
improvement in occupational health and safety services for the workers leading to the
following:
 Establishment of Environmental and Occupational Health Division of Federal
Ministry of Health
 Establishment of Institute of Occupational Health by Oyo State Ministry of Health
at Ibadan
 Directive that all states of the federation should set up occupational health and
safety units. This was agreed at the 1980 National Council on Health at the Jos
meeting
  Integration of occupational health into the course curriculum of preventive
health personnel of various cadres
 Establishment of occupational health department in some Nigerian universities.
The various bodies undertake various activities to improve the services of occupational
health. Such services include:
- Training of industrial nurses
- Training of first aiders
- Organization of workshops on occupational health and safety
- Health surveillance of workers
- Research
- Consultancy services etc.
WORK ENVIRONMENT AND PRODUCTIVITY
The work environment can affect workers productivity (output) positively or negatively.
Work should be a means of economic survival, source of satisfaction, happiness, social
status and companionship but it can also result to stress, dissatisfaction, threats to
workers’ health and well-being. Poor work environment reduces productivity and
workers’ efficiency whereas conducive work environment improves workers’ efficiency
and productivity.
The work environment according to Opperman (2002) comprises three major sub-
environments namely:
1. The technical environment: Technical environments include tools, equipment,
technological infrastructure and other physical or technical elements. This environment
creates elements that enable workers perform their respective responsibilities and
activities.
2. The human environment: The human environment includes peers, others with whom
workers relate, team and work groups, interactional issues, the leadership and
management. Human environment is designed in such a way that it encourages informal
interaction in the work place so that the opportunity to share knowledge and exchange
ideas could be enhanced. This is the basis to attain maximum productivity.
3. The organizational environment: The organizational environment includes systems,
procedures, practices, values and philosophies. Management has control over
organizational environment. For example, measurement system where people are
rewarded on quantity (rather than quality) hence workers will have little interest in
helping those workers who are trying to improve quality. Issues of organizational
environment influence workers productivity. Productivity in an organization can in
principle be influenced by a wide range of internal and external factors which may be
categorized thus:
(a) General factors: General factors include climate, geographic distribution of raw
materials, fiscal and credit policies, adequacy of public utilities and infrastructural
facilities etc.
(b) Organizational and technical factors: These include the degree of integration,
percentage of capacity, size and stability of production.
(c) Human factors: These include management relations, social and psychological
conditions of work, wage incentives, physical fatigue, and trade union practices.
FACTORS THAT ENHANCE PRODUCTIVITY
The factors which either contributes positively or negatively to worker’s productivity
are: temperature, humidity and air flow, noise, lighting, worker’s personal aspects,
contaminants and hazards in the work environment and types of sub-environment. Kyko
(2005) identifies two types of work environment namely conducive work environment
and toxic work environment.
 Conducive work environment gives pleasurable experience to workers and
enable them to actualize their abilities and behaviours. This type of environment
also reinforces self-actualizing behaviours. For example, an irresponsible worker
can change into a responsible worker in a conducive environment.
  (b) Toxic work environment gives unpleasant experiences and at the same time
decasualizes workers’ behaviour. This environment reinforces low self-actualizing
behaviour and it leads to the development of negative traits in workers’
behaviour. In toxic work environment, responsible and sensible worker can
change into irrational and irresponsible worker as a survival strategy.
RELATIONSHIP BETWEEN WORK AND HEALTH/INTERACTION BETWEEN WORK AND
HEALTH
The understanding of the relationship/interaction between work and health is very
fundamental to the understanding and practice of occupational health and safety. This
is because both work and health has effect on each other. However, the goal of
occupational health is to minimize or even totally eradicate or eliminate of mutual effect
of both work and health on each other while at of same time enhancing the ---- effects.
Positive effect of work on health
1. It relieves boredom (‘’idle mind is the devil workshop’’)
2. Provision of avenue for creativity.
3. Provision of personal gain amidst of livelihood
4. Provision of sound health (the body is unknowingly exercised as work goes on).
5. Prevention and control of obesity as calories are burn in the cause of work.
6. The building of a sense of self worth.
7. Provision of avenue for interaction with other workers, thereby reducing the
tendency of mental imbalance the may be secondary to loneliness.
8. Work has euphoric function.
Positive effect of health on work
1. Disposition and capacity to work and get a job if so desired.
2. High productivity
3. Capacity to enjoy and derive satisfaction from work
 4. Good health enhances concentration and efficiency which lessen wastage thus
reducing cost of production
5. Stimulate others to good work
6. Reduction of accident rate their by reducing insurance claims.
7. Health is wealth
Negative effects of poor health on work
1. Poor disposition, capacity and potential for work
2. Poor productivity at work
3. The illness might become wild
4. The sick person can constitute danger to other workers
Negative effect of work on health
The negative things that happen to workers from overwork or underwork (employment)
ranges from stress, mental, emotional breakdown, burnout, injury sometimes result in
disability or death and a wide range of diseases. Workers are exposed to hazardous
ailment from the component of work environment which may result into any of
aforementioned health problems.
PROMOTION OF WORKERS WELLBEING IMPROVEMENT OF WORKING CONDITION
 Provision of balance diet  Satisfactory design
 Adequate rest and relaxation  Maintenance of machinery
 Job satisfaction or motivation  Provision of ventilation, lighting and
atmospheric purity.
 Understanding and cooperation  Provision of safety equipment
among employer, management and
employees
 Promotion of personal hygiene  Better relationship between man
and machine
 Pre-employment or periodic  Provision of adequate sanitation
 medical exams conditions and good housekeeping
 Provision of accommodation and  Regular inspection of working
transport to work environment
 Adequate training and health SAFE WORKING CONDITIONS AND
education OPERATIONS

HEALTHY WORKFORCE
LOW ACCIDENT RATE
LOW SICKNESS AND ABSENCE

ENHANCEMENT OF
EFFICIENCY AND HIGH
PRODUCTIVITY

COMPONENTS OF THE WORK ENVIRONMENT

The five components of the working environment are; physical environment, chemical
environment, biological environment, mechanical and social/psychosocial environment.
PHYSICAL ENVIRONMENT:
The physical environment consists of non living things such as the H2O, temperature,
heat, air etc. As good as these components or conducive as they may be to human
being, they also constitute some hazards to healthy living. The followings are some of
the hazards associated with each one of them;
HAZARDS ASSOCIATED PROBLEMS
 Exposure to high  Heat stroke, heat cramps,
temperature heat rashes, burns, heat
exhaustion
 Exposure to low  Frost bite, chills
 temperature
 exposure to bright or  Eyes stress, loss of vision
excess light
 exposure to inadequate  Accident, loss of vision,
light eye stress
 exposure to excessive
noise (usually measured  Hearing problem
in decide del de)
 exposure to radiation  Burns, cancer, radiation
(ionizing and non ionizing sickness
radiation)
 exposure to high humidity  Exhaustion

CHEMICAL ENVIRONMENT: it is made up of compound and mixture in the work place. It

is by far the most rapidly and expanding component of work environment. More and
more new chemicals are been introduce into the work environment and many of the
occupational diseases that emanate from exposure of individual to these chemical could
take up to 10-40yrs.
Most of chemical that constitute health hazards are inform of dust, fumes and solid,
vapour, gases, mist. In other for each agent to cause health problems it must come in
contact with body cells. The major modes of entering of these substances are inhalation,
ingestion and skin absorption. Some of the chemical hazards and problems cause with
them are as follows:
HAZARDS ASSOCIATED PROBLEMS
Exposure to lead Anemia, intestinal coli, nervous and
mental breakdown
Exposure to mercury Nephrosis, chronic kidney diseases,
nervous and mental disorder
Exposure to Nickel Nasal cancer, nasal sinuses
Exposure to Benzene Leukemia
Exposure to asbestos Abestosis(fibrosis of the lungs),
mesothelinoma (rare cancer of chest and
lining, pleural plates, lung cancer
Exposure to silica Silicosis (pneumoconiosis). Silicosis
substantially raises the risk of other lung
diseases particularly TB, bronchitis and
emphysema
Textile dust (dust from flower, flower Byssinosis (brown lung)
hemp)
Wood dust Causes cancer of the nasal cavity and
sinuses
Exposure to arsenic Skin, lung and liver cancer

Coal dust Obstruction of air way, pneumoconiosis

(black lung)
Exposure to leather Cancer of the nasal cavity, urinary bladder
and sinuses
Allergies Asthma attacks, hypersensitivity
pneumonitis (lung inflammation). In
prolong exposure. It could result into
irreversible pulmonary fibrosis
BIOLOGICAL ENVIRONMENT: The work environment consists of all kinds of living
organisms like bacteria, viruses fungal, protozoa, rickettsia, etc. some of these can cause
diseases in man that are exposed to them.
BIOLOGICAL HAZARDS ASSOCIATED PROBLEMS
Bacillus Anthrax
Tubercule Bacilli Tuberculosis
Clostridium tetani Tetenus
Brucella spp. (small gram negative cococci) Brucellosis
Neisseria Gonococcus Gonorrhea
Leptospira interorganes Leptospirosis
VIRAL AGENTS ASSOCIATED PROBLEMS
Rabies virus Rabies
HIV AIDs
Hepatitis virus Hepatitis
FUNGAL AGENTS ASSOCIATED PROBLEMS
Candida Dermatophytosis, Histplastosis,
actinomycosis, candidaisis
PARASITIC AGENTS ASSOCIATED PROBLEMS
Ankylostoma Ankylostomasiasis
Schisotoma spp Schistosomiasis
Plasmodium spp Malaria

MECHANICAL ENVIRONMENT: It actually consists of various sizes and shapes. Some are
sharp, other are blunt, sharps or rough edged. Some are electrically operated while
others are manually operated. Any of these may result in varying degrees of accidents
and injuries which may give rise to blood loss, deformity, electrocution, death.
Arthritis and vibration, white fingers, may result from exposure to vibrating equipments.
Health practices to control hazards are shifted to mechanical environment consist of
modification of these tools to decreased the hazards associated with them e.g
grounding, muffling.
SOCIAL ENVIRONMENT: It consists of man to man interface in the workplace. This has
to do with the relationship between the employer and employee, the boss and the
subordinates and relationship between co-workers and religion and different groups.
Therefore, when there is rivalry, nepotism, gossips, denial of right, usage of repulsive
management techniques constant industrial action e.t.c.
There may be development of antisocial behavior, development, feeling of insecurity,
stress, mental imbalance, alcoholism and high blood pressure.
OCCUPATIONAL ACCIDENT
An accident is an unexpected event that occurs without an apparent cause of the time
of happen and interferes with the process in action. It usually results in economic loss,
human injuries or death.
An occupational accident is an accident that occurs to a worker during his working hours
or due to his working obligation. Occupational accident includes any accident that
happen to a worker while going to work or back home from work within 1 hour from the
beginning and 1 hour after end of his working hours, on condition that he does not
divert from his normal route to work and to his home.
CAUSES OF OCCUPATIONAL ACCIDENT
The causes of occupational accident can be grouped into 3 categories:
A. Causes due to work environment
1. Condition of building and its unfitness for the type of activities taken place in it
2. Inadequacy of rooms for workers, machinery and processes.
3. Inadequacy of absence of effective ventilation and lightening
4. Presence of slippery floor and careless catering of tools (poor housekeeping)
5. Inadequacy of entrance and exit doors
6. Defective stair cases and mobile stairs
B. Causes due to machinery and equipments
1. Absence of covers or guards on all rotating expose parts of machines including
belts
2. Presence of exposed electric or wire and careless exposure of electric connection
3. Absence of proper regular maintenance of machine and equipment
4. Careless in processing and handling mechanical cranes
5. Negligence in maintaining boilers of other equipments after operate under
pressure
6. Negligence in the storage and transportation of flammable and explosive
materials.
C. Causes pertaining to the worker
1. Insufficient training of workers before employment
 2. Careless of the workers in carrying out their work according to rules and
regulation.
3. Speed at which the worker perform their work the more the speed the higher the
risk of accident.
4. Usage of wrong tools for a job
5. Negligence in wearing the personal protective device by the worker
6. Interference with fellow workers job
7. Trying to joke and have fun while performing work
8. Coming to work drunk or under the influence of drug
CONSEQUENCES OF OCCUPATIONAL ACCCIDENT
It could be look from two perspectives:
A. Direct effects: Direct damage to machinery, properties or human beings
B. Indirect effects:
1. This includes time lost by management and others in investigating accidents.
2. Time lost in idleness and low productivity due to danger of machines and
equipments
3. Losses due to absenteeism of injured worker (including the cost of treatment)
4. Loss due to repair and placement of damage machinery and other things.
5. Loss due to psychological effects on fellow worker especially when they are eye
witness of the injury and disability of their injured worker
6. Loss due to time spent on rehabilitation of injured worker
CONTROL OF OCCUPATIONAL ACCIDENT
A. Control due to work equipment
- Building should be designed in order to accommodate safety of industrial activity
take place in it
- Provide sufficient room space for both the machine and the free and save
movement of workers within every work space.
 - Provide for adequate lightening, ventilation and temperature control to conform
with the necessities of process in question
- It should provide for regular disposal of industrial refuse
- It should provide for suitable floors free from crack and irregularities
- It should provide for adequate doors for free entrance and exit of workers in case
of emergency.
B. Control pertaining to machinery and equipment
1. All machines should be designed for safety or economically designed including
the chair we are sitting on.
2. All rotating exposed part and belt should be covered or locally shield
3. Regular maintenance of cranes and other machines
4. Regular oiling of the part of require oiling
5. Prompt and adequate repair of faulty engine and replacement of worn out part
6. Proper installation of all electrical connection and wire
7. Ensures the security of all robes and belts
C. Control pertaining to the worker
- Workers should always follows the same save working procedure
- Workers should avoid carelessness in all respect
- Wearing of personal protective equipment while at work
- Avoidance of alcohol or drugs
- Health education of the workers regarding the importance of performing their
work according to safety regulation is that they will not only do so themselves
but help to warn other negligence fellow workers
NEEDLE STICK INJURIES
Puncture of the skin caused by injection needle, could occur in the course of use,
disassembling and disposing of injection needles.
CATEGORY OF HEALTH CARE SCIENCE INDIVIDUAL AT RISK
  Nurses, physician, medical laboratory technologist
 Housekeeping staff, patients/clients, community.
 Laundry workers, waste collection personnel
CAUSES OF NEEDLE STICK INJURY
 Carrying around used syringes and needle and careless handling of syringe and
needle needed to be dispose
 Recapping needle
 Reaching unto a container of used needle and syringes
 Manually detaches needle from syringes
 Manipulatory used sharp needle
 Passing on sharp needle from one health worker to another
 Overfilling safety boxes
 Using a syringe and needle in areas accessible to the public especially children.
 Sharing syringe and needle
 Re-using syringe and needle
EFFECTS OF NEEDLE STICK INJURY
 Transmission of blood borne infection like HIV, Hepatitis B and C
 Trauma with associate pain
 Cellulitis
MANAGEMENT OF NEEDLE STICK INJURIES
- Allow wound to bleed freely (if it is bleeding)
- Wash with soap and running water
- Alert your supervisor
- Identify source patient
- Immediately report to the designated person/facility
- Document the incident
- Get post-post test counseling
 - Get post-exposure prohylaxis (PEP) within 2 hrs if possible
- Evaluate injuries; immediately, after 6 weeks, 3 months, and 6 months.
- Conduct follow up on 6 monthly basis
PREVENTION OF NEEDLE STICK INJURIES
- Employee training (capacity building)
- Adherence to recommended guidelines
- Effective disposal system
- Improve equipment design
- Surveillance programme
OCCUPATIONAL DISEASES
There is no internationally accepted definition for the term occupational disease,
however occupational diseases are usually defines as diseases arising out of or in the
course of employment. It could also be defined as any recognized chronic ailment that is
known to occur in a given body of workers in a given industry at a rate far higher than it
occurs in the general population and includes disease that are only known among
workers in a given industries and nowhere else.
OCCUPATIONAL DISEASES IN HEALTH CARE ESTABLISHMENTS
Occupational diseases in health care establishment are tuberculosis, serum hepatitis.
Tuberculosis
(i) Occurrence: Tuberculosis disease is world-wide. It is an occupational risk of health
workers in hospitals and sanatoria who care for patients with disease. It is also prevalent
among occupations like mining, cattle rearing, agricultural workers and veterinarians.
(ii) Infectious agents: There are two types of tubercule bacilli that affect man and they
include:
(a) Mycobacterium tuberculosis (Human type). This is responsible for pulmonary
tuberculosis.
(b) Mycobacterium tuberculosis (Bovine type). This affects cattle more than man.
(iii) Incubation period: From four to six weeks
(iv) Mode of transmission:
(a) Human Type: Infection is primarily due to close or frequent contact with an infective
case by reason of employment. Doctors, nurses, and other paramedical in close contact
with infected materials are at high risk of infection.
(b) Bovine type: Infection is due principally to ingestion of infected milk.
(v) Signs and symptoms: Signs and symptoms are painful cough, weight-loss, chest pain,
fever, anaemia, slight rise in normal body temperature in every evening.
Hemoptysis (blood in sputum) occurs frequently.
(vi) Preventive measures:
(a) A heaf test should be done as routine for the occupationally exposed persons, for
example, nurse, miners, and pathologist. BCG vaccine offered to those found to be
negative. Heaf test must be repeated every five years in order to identify those that
have reverted to negative.
(b) Protective masks must be worn by pathologists, nurses and other paramedical when
dealing with active case.
(c) Industrial survey must be carried out for early detection of those with the disease.
(d) Health educate workers on the ways and methods by which tuberculosis could be
spread, for example, discourage indiscriminate spitting in work environment and public
places.
(e) Provision of good and workers. Bad and unsuitable housing contributes to
continuous existence of infection in a family.
Serum Hepatitis B
(i) Occurrence: Serum hepatitis B occurs world-wide and its endemicity is seasonal and
varies. This disease is found mainly in medical and Para-medical staff, especially those
working in renal dialysis units, blood transfusion centres, veneral disease clinics and
laboratories.
(ii) Infectious agent: Probably a virus.
(iii) Incubation period: From 80 to 100 days
(iv) Mode of transmission: The virus gets into the body by inoculation either orally or
through veneral spread.
(v) Signs and symptoms: The disease is manifested by acute fever, headache, marked
malaise, and fever with jaundice. This can be fatal and is more severe than infective
Hepatitis A.
(vi) Preventive measure:
(a) All blood meant for transfusion should be screened medically.
(b) Occupationally exposed workers should be well protected.
(c) Health education is essential.
DEFINITION AND MEANING OF SAFETY
Safety has been defined as a state of being free from danger, harm or injury; a state of
being safe, a state of being resulting from the modification of man’s environment and
behaviour (Onuzuike, 2003).
History reveals that the early man, out of safety consciousness, lived in caves or
treetops to protect himself against dangerous wild beasts and enemy tribes. He soon
learned to cover the entrance to his cave with a huge stone. As time went on, man
invented tools and weapons. He equally learned to build stronger and safer places
(houses) in which to live.
In 18th Century, during the Industrial Revolution, there was a remarkable advancement
in technology that brought about the invention of machines. This breakthrough led to
the employment of machines in the production of goods, which the craftsman
previously produced manually. In this way, there was transition in production from
‘manpower’ to ‘machine-power’ and from production in the home to production in the
factory. With the advent of the machine, with its characteristic moving parts, cutting
blades and power operation, came many new types of hazards, accidents and injuries,
both in the workplace, at home, and in other settings.
We must therefore learn how to remove all potential hazards and dangers around us
and/or compensate for those which cannot be removed. People should cultivate safety
consciousness as a part of their life philosophy. They should be able to identify the
various hazards in their environment, as well as know how to control them so as to
minimize accidents and the problems associated with them.
SAFETY MANAGEMENT CONCEPT
Safety management concept covers areas such as, personnel, premises, equipment,
integration, safety and health check-ups.
PERSONNEL
The health and safety of your workers should be at the top of the list of priorities for all
establishments. Aside from the obvious terrible impact of a worker getting injured or
dying, there are other negative effects such as raising accident-related costs or facing
expensive law-suit. Moreover, preventing injuries and illnesses in the workplace can
reduce absenteeism, lower turnover, raise productivity and improve workers morale.
Workers should be aware of their surroundings and report any suspicious behaviour as
they see fit. It is better to be safe than sorry, so encourage workers not to be shy and
speak up if they think something does not seem right.
PREMISES
Buildings, parking lot and anywhere else where workers or equipment are should be
kept safe at all times. Whatever type of security system provided surveillance cameras
should be set up throughout the building as well as around the outside. Every walkway,
doorway and entryway should be kept clear of any obstacles in case of emergency to
prevent potential accidents. There should be also emergency plans set in place for every
part of the premises for any type of emergency.
EQUIPMENT
All equipment should be up to date and ready to use or it should not be used at all.
Regular maintenance should be conducted on all equipment and any and all problems
should be reported and recorded for easy look up. Make sure that any worker who uses
the equipment is properly trained and understands how to inspect the equipment on his
own before using it.
INTEGRATION
Every safety programme should be integrated into all aspects of the company and
should be emphasized just as much as production, sales and quality control. Safety
procedures should not be considered separate of anything else but a part of everything.
That way, it is just assumed that everything is done as safely as possible as it should be
instead of taking extra time to focus on safety and then basically forgetting about it.
A good way to integrate health and safety procedures into everyday life is to make it a
part of the company’s incentive programme as well.
SAFETY AND HEALTH CHECK-UPS
In order to be certain that the company has the highest standards for safety and health,
it is necessary to have frequent check-ups. Even if the company has gone a long time
without any injuries in the workplace, still do frequent check-ups to make sure that no
departments or workers are getting complacent. Certain indicators that can be used to
gauge the level of safety are statistical reports, opinion surveys, risk analysis, periodic
inspections, and process improvement initiatives. Make sure that all the workers answer
any and all questions completely truthfully. The point of these check-ups is not to get
anyone in trouble, but to constantly improve the level of safety throughout the
company.
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