Chapton14 Occupational Health

Syllabus
ofoccupational health and Ergonomics. Occupational Hazards and Occupational diseases
Role of
Definition
control of Occupational diseases. ESI Act ,1948 and The factories Act. 1948.
Examination
Prevention and bealth problems. The Merchant Shipping / Medical
Ayurveda in various Occupational
Rules 2000.
Learning objectives

Define Occupational Health and Ergonomics.s

2. Explain occupational Hazards.
explain their prevention &control.a
3. Enlist occupational diseases and factories Act, 1948.
4. Explain ESI Act, 1948 and The
Occupational health problems.
5. Describe the role of Ayurveda in various Examination Rules, 2000
6. Understand the Merchant Shipping / Medical
Total -6 hours (Lecture :3 hour, Non-lecture: 3 hours)
MCQ- Yes- SAQ (5 Marks)- Yes- ILAQ (10 Marks)- No

dealing with the prevention and treatment of job

According to WHO occupational health should related injuries and illnesses.
aim at the promotion and maintenance of highest
degree of physical, mental and social wellbeing of Modern concepts of occupational health now
workers in alloccupations. The prevention among embrace all types of employment including
workers of departures from health, caused by their mercantile and commercial enterprises, service
working conditions, the protection of workers in trades, forestry and agriculture and includes the
their employment risks resulting from factors subjects of industrial hygiene, industrial diseases,
adverse to health. The placing and maintenance of industrial accidents, toxicology in relation to
workers in an occupational environment adopted industrial hazards, industrial rehabilitation and
to his physiological and psychological equipment occupational psychology. Occupational health in
and to summarize the adoption of work to man and agriculture and ergonomics (human engineering)
of each man to his job. are relatively new concepts.
Bernardino Ramazzini (1633-1714) of Italy Definition of Ergonomics- the study of
was the first person to stress the importance of people's efficiency in their working environment.
taking occupational history of a patient. He wrote
on occupational diseases. He is considered as Itis a new concept in occupational health. It is
"Father of Occupational Health". concerned with human engineering. It is derived
from Greck words, 'Ergon' means work and
Occupational Health And Ergonomics 'Nomos' means law. It simply means "fitting the
job to the worker." That means placing the worker
Definition of Occupational Health- The in an environment (job), which is adopted to hs
common definition of the branch of medicine physiological and psychological capacity.
 Occupational Health 551

The main object of ergonomics is to achieve environment which may be adverse to health are
the best mutual adjustment between the man and heat, cold, humidity, air, movement, heat radiation,
the machine, which are complimentary to cach light, vibrations, ionizing radiation etc. factors act
other, so that therc is increased efficiency, increascd in different ways singly and in different
oroduction and decreased accidents in the industry. combination
This term was coincd in a conference at
Chemical: These include large number of
Stockholm in 1961, conducted by International chemicals,
Ergonomics Association. Ergonomics has made a hazardous to toxic dusts and gases which are
the health of workers.
significant contribution in reducing the industrial
Bccidents and in overall health and efficiency of vial.Biological: Workers may come in contact to
the workers. rickettisal, bacterial and parasitic agents due
The health of the worker is influenced by 3 to close contact with animals or their products,
factors. Namely occupational (working) contaminated water, soil and food.
environment, domestic environment and social Man and Machine- The interaction between
security and welfare measures. man and machine. In almost all the industries, the
Burden of Occupational Diseases- There are machines are driven by power. Poor installation of
100 million occupational injuries causing 0.1 machines, the unguarded machines, protruding and
moving parts, poor maintenance etc. result in
million deaths in the world according to WHO. accidents. Working for long hours result in fatigue,
In India, it is estimated that 17 million (17% of discomfort and diseased efficiency.
global burden) occupational nonfatal injuries and Man and Man -The interaction between the
45,000 fatal injuries occur cach year. Out of 11
million cases of occupational diseases in the world.worker and his co-workers and the employer. This
1.9 million cases (17%) are contributed by India depends upon many psychosocial factors at work
and out of 0.7 million deaths in the world 0.12 place like nature of the work, colleagues,
million (17%) is contributed by India. communications, higher authority, system of
Aims :
payments, welfare conditions, work stability.
degree of responsibility, service condition, job
1. To increase the efficiencyi satisfaction, incentives etc.
2. To increase the production
3. To decrease the accidents Occupational Hazards
Objectives: An industrial worker is exposed to the following
1. To promote the health of the workers. five types of hazards (Physical, chemical,
2. To maintain the highest degree of physical, biological, mechanical and psychosocial hazards).
mental and social wel being of the workers. depending upon the nature of the occupation.
3. To prevent the discases by elimination of Physical Hazards
factors which are inimical to their health.
Occupational Environment Conditions- All . Heat: The effects are heat syncope, heat
the external conditions and influences, which is cramps, heat exhaustion, heat stroke, heat
hyperpyrexia, prickly heat, burns etc.
present at the work place and which influence the Cold: Frost bite, Reynaud's disease,
health of working personnel is occupational
environment. Man interacts with physical, chemical t erythromelalgia, erythrocyanosis, chilblains,
trench-foot, gangrene ctc.
and biological agent, machine and other men. . Heat syncope- It is fainting attack due to
Man and Physical, Chemical, and Biological pooling of blood in lower limbs.
agents
Physical: The physical factors in the working| Heat cranmps- It is painful and spasmodic
 Swasthavritta evam Yoga
S52
joints of fingers, hands, clbows and shoulder
contractions of muscles due to loss of scodium may occur.
radiatlonExposur
and chloride.
Exposure to Utra-violet the skin- Darkenine
.Heat exhaustion- lt nmeans loss of salt leading to Ultra-iolet radiation-On
on to circulatory failure. thickening ofthe skin, erythema cancer
perpyrevia- t is characterized by ofthe skin,
skin. On the cyes (E.g. -Weldine)
.Heat hyT mechanisn1 without of the conjunctivitis,keratitis,,corneal ulcer,
failure in heat regulating Photophobin,
abot blindness (Welder's fish), snow blindness.
the features of heat stroke. Tenyerature is radiationExposure to
106 åF. lt may pceed tobeheat stroke. Exposure to lonizing radio-active isotopes
failure in the heat
" Heat stroke- There will
resulting in high onizing radiation- X-rays, 32 produce genetie
regulating mechanism,deliriun, convulsions, 60. phosphorus cancer, leukemia,
like cobaltmalformations,
temperature of the hody.consciousness. changes, extreme cases.
partial or total loss of pain are ulceration, sterility and death in
"Frost bite- Erythema and slight paraesthetic Chemical Hazards
features. In severe case painless,destruction, Local,
parts, result in decp seated Chemical agents act in 3 ways:depend on
gangrene and blistering may occur. Inhalation and Ingestion. The ill effects
Erythrocyanosis- Limbs are swollen and red duration of exposure, amount and individual
. susceptibility.
due to direct exposure to cold.
burning
.Chilblains- Erythema, itching.hecls, 1. Local effects: Dermatitis, eczema, ulcer and
especially of dorsa of fingers, toes,nose, even cancer.
Lesions can
cars on exposure to extreme cold. a. Denatitis due to allergy- machine oils, rubber,
be single or multiple and can become blistered X-ray, Caustic alkalies, lime etc.
and ulcerated.
b. Aromatic nitro and amino-compounds such
" Light- Effects occur either due to inadequate as TNT and aniline are absorbed through skin
light or excessive light. and cause systemic effects.
. Inadequate light- Headache, eye strain, eye 2. Inhalation: Dusts, fumes, gases and metals
fatigue, eye pain. and their compound.
.Excessive light- Bright light results in glaring. . Dusts-Dusts are fincly divided solid particles
visual fatigue, blurring of vision, discomfort with size ranging from 0.1 to 150 microns.
and accidents.
. Noise- Noise is a health hazard in many They are released into the atmosphere during
industries. The effects of noise are of two types. erushing, grinding, abrading, loading and
NoseAuditory effects Deafness (emporary unloading operations. Dusts are produced in a
or permanent), tinnitus (buzzing in the cars). number of industries nmines, foundry, quary.
Non-Auditory effects- Fatigue, irritability. pottery, textile, wood or stone working
nervousness, interference with speech and industries, Example- Paeumoconiosis.
communication, hypertension, peptic ulcer, Fumes- Metal fume fever (This chemical
higher environmental stress. intoxication results from inhalation of fumes
. VibrationVibration- Frequency range 10 of molten metals like arsenic, antimony.
500Hz, when working with tools like drill, beryllium, cadmium, cobalt, lead, zinc,
hammers etc. vibration generally affects hands mercury tc.)
and arms. Afer months and yeas of "Gases- Exposure to gases is acommon hazard
fine blood vessels of fingers mayexposure,
become in industries.
increasingly sensitive to spasm, injuries to a. Simple gases- O2, H2
 Occupationnl Health 553
h. Asphyxiating gases- Co,
methyl isocyanides gas ctc. s02, C12, H2S, e) Noise-Occupational deafness.
e. Anaesthetic gases- Chloroform, ether, 9Radintion- Cancer, leukemia, aplasticanemia,
trichloroethylene pancytopenin.
Ingestion: Toxie hazards occurring from the g) Mechanical factors- Injuries, accidents.
octals like lead, arsenic, h) Electricity- Burns.
manganesc, chromium ete, mercury, cadmium, 2. Diseases due to chemical agents
Biological Hazards a) Gases- CO2, CO, HCN,CS2, NH3, N2, H2S,
HCI, SO2 these cause gas poisoning.
Workers may be exposed to infective and b) Dusts (Pneumoconiosis)
parasitic agents at the place of work. These are from L Inorganie dusts
the animals and soil. These are common in
agricultural industry,. " Coal dust- Anthracosis
From the animals- they are called 'Zoonotic " Silica- Silicosis
diseases'. Ex: Anthrax, rabies, plague, "Asbestos- Asbestosis, cancer lung
salmonellosis, bovine tuberculosis. . Iron- Siderosis
. From the soil- Tetanus, I. Organic (Vegetable) dusts
gag-gangrene,
malignant oedema, anthrax, mycetoma. " Cane fiber- Bagassosis
Mechanical Hazards- 10% of accidents in the " Cotton dust- Byssinosis
industry are due to mechanical causes. " Tobacco- Tobacossis
Psyehological Hazards- These are due to .Hay or grain dust- Farmer's lung
failure of the worker to develop a healthy II. Metals and their compounds-Toxic hazards
relationship with his co-workers, employers, from lead, mercury, cadmium, manganese,
management, supervisors etc. They are divided into berylium, arsenic, chromium etc.
two groups. IV. Chemicals- Acids, alkalis, pesticides
1. Psychological and behavioural changes: Such V. Solvents- Carbon bisulphide, benzene,
as hostility, aggressiveness, anxiety, trichloroethylene, chloroform etc.
depression, frustration, tardiness, alcoholism, 3. Diseases due to biological agents
drug addiction, sickness absenteeism etc. Brucellosis, leptospirosis, anthrax, actino
2. Psychosomatic ill health: Such as neurosis, mycosis, hydatidosis, psittacosis, tetanus,
fatigue, propensity to peptic ulcer, encephalitis, fungal infcctions ctc.
hypertension, asthma etc. 4. Occupational cancers- Cancer of skin, lungs,
bladder.
Occupational Diseases and their Preve
ntion and Control
5. Oceupational dermatitis- Dematitis, eczema.
6. Diseases of psychological origin- Industrial
1. Diseases due to physical agents neurosis, hypertension, peptic ulcer ete.
a) Heat- Heat hyperpyrexia, heat exhaustion, heat Occupational Dermatitis
syncope, heat cramps, burns and local effects
such as prickly heat. Occupational dermatitis is a big health problem
b) Cold- Trench foot, frost bite, chilblains. in many industries. The causes may be:
c) Light- Occupational cataract, miner's 1. Physical- Heat, cold, moisture, friction,
nystagmus. pressure, X-rays and other rays.
d) Pressure- Caisson disease, air embolism, blast 2. Chemical- acids, alkalies, dyes, solvents,
(explosion). grease, tar, pitch, chlorinated phenols.
 554 Swasthavrita evan Yoga

3. Biological- living agents, such as viruscs, of crystalline silica dust and is

bacteria, fungi, and other parasites. inflammation and scarling in forms of marked
by
4. Plant produets- Lenves, vegetables, fruits, lesions inthe upper lobes of the
flower, vegetnbles, dust.
lungs. nodula
It is atype
of pneumoconiosis, from pneumo (lung) and k
Dermatitis producing ngents are further (dust).
classified into: Causes: Because of the wide presence of
I. Primary iritants- Primary irritants (e.g. crystalline silica in nature in an undisturbed form,
Acids, alkalies, dyes, solvents)cnuse dermatitis inas in rocks and the earth's crust, people n
workers exposed in sufficient concentration ncid involved
occupations that disturbor the
in collecting naturalthestate
refining or thye
materíal are
for a long enough period of time.
2. Sensitizing substance- On the other hand, at risk of developingsilicosis.
allergic dermatitis oceurs only in snmall percentage These occupations include the following:
of cases due to sensitization of the skin. mining, querying. drilling. crushing stones
Prevention: Occupational dermatitis is largely chipping. grinding, sand blasting. grinding o
preventable if proper control measures are adopted.polishing, in pottery and foundry work, cemem
manufacturing. glass manufacturing, masonry, blas
Pre-seleetion- The workers should be
medically examined before employment, and those furnaces, coal mining, construction, cutting or
with an established (or) suspected dermatitis. manufacturing heat resistant bricks, dental
laboratory technicians.
Protection- The worker should be given
adequate protection against direct contact by Signs and Symptoms
protective clothing, long leather gloves, aprons, and 1. Dyspnoea exacerbated by exertion
boots. The protective clothing should be frequently 2. Cough, often persistent and sometime severe
washed and kept in good order. 3. Fatigue
Personal Hygiene- There should be available
a plentiful supply of warm water, soap and towels 4. Tachypnea
the worker should be encouraged and educated to 5. Loss of appetite and weight loss
make frequent use of these facilities. 6. Chest
7. Fever
Pneumoconiosis 8. Gradual dark shallow rifts in nails eventually
Dust within the size range of 0.5 to 3 micron, leading to crack as protein fibre within nails
is a health hazard producing, after a beds are destroyed.
of exposure, a lung diseasevariable period In advance cases:
known as
pneumoconiosis,
man
which may gradually cripple a
by reducing his working capacity
1. Cyanosis
2. Corpulmonaleoitug0
fibrosis and other complications. The due to lung
effects of dusts on the Ilungs depend uponhazardous
a number
3. Respiratory insufficiency.
of factors such as (a) Diagnosis
chemical
fineness (c) concentration of dustcomposition (b)
in the air (d) 1. History collection
period of exposure and (e) health status of the 2. Physical examination
person exposed.
3. Chest X-ray reveals findings consistent wit
Silicosis silicosis
4. Pulmonary function testing: may reveal airtlow
Silicosis, also known as Potter's rot is a form limitation, restrictive defects, reduced diffusion
of occupational lung disease capacity, mixed defects or may be normal (u
caused by inhalation
uncomplicated).
 Occepational Health 555

Treatment : Silicosis is an itreversible Treatment: There is no cure for the black lung
= oce. Trestment options curently disease. Treatrments are aimed at the symptoms and
focs cm aleviting
apiaices Thesethe sypeos and preenting complicated.
inctade: Prevention and control:
L Saogping furtber exposure to siica and other 1. Dust control measures like wearing face mask
ng iritts, inclading tobacco. 2. Improving the ventilation of the factory
2 Coegh ppressnts
3 Atibicis for bacterial lung infection. 3. Improving the machinery to reduce the dust
4. Wetting procedures should be carried out so
4 TB prophylaxis for those with positive that the dust will not concentrated in air.
oberclosis skin test Measures of Health Protection in Industrial units
s Ches ptysiotherapy to betp the broachial
dainage of macus. 1. Proper Nutrition
6 Orygen administration to treat hypoxemia, if 2. Communicable disease control
rset Broochodilators to failitate breathing. 3. Enviroment sanitation
7. Lng Mental bcalth promotion
& Trnplattion 5. Health education
6. Protective measures foe women and children
Prevention and control:
7. Family planning
.Rigoroas dast control measures like wearing
mesk improving the vetilation of work place. Byssinosis
.Warspray is often nsed where dust emanates
Byssinosis is a discase of the lungs brought on
" Dast can also be controlled by dry air filtering by breathing in cotton, dust or dusts from other
Anthracosis (Coal Workers vegetable fibres such as flax, hemp or jute while at
Pneumonconiosis) work.
Incidence: In United States, more than 35000
Black lung diseasc, also known as Coal textile workers have been disabled by Byssinosis
worker's pneumoconiosis, is caused by long and 183 died between 1979 and 1992. In India,
exposure to coal dust. It is acondition characterized among 35% of textile industry 7to 8% of workers
by the accumulation of carbon in lungs. are affected with Byssinosis.
Causes: Inhalation of coal dust. Causes:
Risk Factors: Smoking . The most common cause is breathing in the
Signs & Symptoms: No carly symptoms, dust produced by raw cotton.
Cough. Chest pain, Breathing difficulty. Dyspnoca.
Bronchitis. Cyanosis, Progressive lung stiffening.
. People who work in the textile industry
. Smoking increases the risk for this disease.
Shortness of breath, Impaired lung functions Signs and Symptoms :
Diagnosis: . Chest tightness
1. History collection . Progressive Dyspnoea
2. Physical examination Chronic Cough
3. Chest X-ray . Tachypnea
4. Pulmonary function tests . Wheezing
5. Chest CT Scan
6. HRCT- High resolution CT Scan
" Symptoms will get worse at the beginning of
the work week and then improve while you
 Swasthavritta evam Yoga
556
6. Wetting procedures so that the dust will not
are away from the work place, or late in the concentrated in the air.
work weck.
Diagnosis : Bagassosis
1. History collection: Occupation and will ask
many qucstions to try to find out whether
your Bagassosis is the name given to an occupational
relate to certain exposure or times disease of the lung caused by inhalation of baat
symptoms or sugarcane dust. It was first reported in India by
of exposure. Ganguli and Pal in 1955 in a cardboard
2. Physical examination manufacturing firm near Kolkata. India has a laree
3. Chest X-ray
function tests- Shows typicalcane-sugar industry.
4. Pulmonaryobstruction and a reduction Symptoms Breathlessness, cough.
airflow
investigatory capacity, especially if measured haemoptysis and slight fever. Initially there is acta
at the start and end of the first work shift. diffuse bronchiolitis.
Treatment : Diagnosis- Skiagram may show mottling in
1. The most important treatment is to remove the lungs or shadow. There is impairment of pulmonary
function.
source of exposure to the offending agent.
2 Medications such as bronchodilators will If treated early, there is resolution of the acute
usually improve symptoms. inflammatory condition of the lung. If left untreated,
3. Coricosteroids may be preseribed in more there is diffuse fibrosis, emphysema and
bronchiectasis.
severe cases.
4. Stopping smoking is very important for people Prevention and control
with this condition. 1. Dust control - Measures for the prevention
5. Respiratory treatments including Nebulizers and suppression of dust such as wet process,
and postural drainage for chronic Conditions. enclosed apparatus, exhaust ventilation etc.
6. Home oxygen therapy if low blood oxygen should be used.
levels are detected.
2. Personal Protection- Personal protective
7. Physical exercise programs, breathing
exercises and patient education programs are equipment (masks or respirators with
often very helpful for people with a chronic mechanical filters or with oxygen or air supply)
lung disease. may be necessary.
3. Medical Control- Initial medical examination
Complications : Chronic lung disease and and periodical medical check-ups of the
Emphysema.
Prevention and control: workers are indicated.
4. Bagasse Control- By keeping the moisture
1.Controlling dust to prevent the content above 20 per cent and spraying the
disease. occurrence of bagasse with 2per cent propionic acid, awidely
2. Using face masks
the airway. prevent the dust entering used fungicide, bagasse can be rendered safe
for manufacturing use.
3. Improving
the dust is ventilation of the factory so that
reduced. Asbestosis
4.Reduction of dust levels by improving
machinery. Asbestosis is a chronic inflammatory and
3. Stop smoking if you are a textile fibrotic medical condition affectingtne
worker. industryparenchymal tissue of the lungs caused by
inhalation and retention of asbestos fibres.
 Occupational Health 557
Causes:
2. Dust control measures like wearing mask,
1. Exposure to asbestos fibers wetting procedures, ventilation should be
2. Occupation like mining, manufacturing, improved in the work place
handling or removal of asbestos are at risk of 3. Frequent rest periods
developing asbestosis.
4. Usage of sophisticated machines.
3. Smoking increases the risk of developing
asbestosis.
Farmer's Lung
Signs and symptoms:
Farmer's lung is due to the inhalation of mouldy
1.Dyspnoca especially on exertion hay or grain dust in the agricultural field. In grain
2. Chest pain dust or hay with a moisture content of over 30
3. Cough, crackles present percent, bacteria and fungi grow rapidly, causing
Possible additionalsymptoms include : a rise of temperature to 40 to 50 deg.C. This heat
1. Nail abnormalities encourages the growth of thermophilic
2. Clubbing of fingers actinomycetes, of which Micropolyspora faeni is
Diagnosis: the main cause of farmer's lung.
Symptoms- The acute illness is characterized
1. History collection about the occupation and
will ask many questions to try to find out by general and respiratory symptoms and physical
whether you relate to occupation signs. Repeated attacks cause pulmonary fibrosis
2. Physical examination
and inevitable pulmonary damage and cor
pulmonale. It is quite possible that this condition
3. Chest X - ray shows lung changes might be widespread in India considering the bulk
4.CT scan of the lungs shows the specific areasof the population engaged in agricultural work.
affected Diagnosis- X"ray chest shows 'fine nodular
5. Gallium lung scan shows the specific areas density
affected
6. Pulmonary function tests show typical airway Prevention and control
obstruction and a reduction in ventilator 1. Dust control measures like wearing mask,
cover the mouth and nose by cloth.
capacity.
Treatment:
2. Frequent rest periods.
1. There is no cure available List of Pnemoconiosis

2. Stopping further exposure to asbestos is Disease Exposure source

essential Silica dust
chest Silicosis
3. To ease symptomns, postural drainage,
remove Anthracosis Coal dust
percussion and vibration can help Asbestosis Asbestos dust
secretion from the lungs.
Byssinosis Cotton fibre
4. Nebulizers to thin secretions
by mask or by a plastic piece Bagassosis Molasses (sugarcane)
5. Oxygen therapy Berylliosis
nostrils
that fit the Beryllium
6. Lung transplantation Farmer's Lung Mouldy hay
Complications: Malignant mesothelioma Siderosis Iron dust
AND Pleural effusion Stannosis Tin dust
Prevention and control: Bird fancier's lung Avian/ bird droppings
carly
1. In people who are exposed to asbestos, Compost lung Compost
screening by chest X-ray
 Swasthavritta evam Yoga
558
dust is present. Floors, benches, machines
Lead Poisoning should be kept clean by wet sweeping.
More industrial workers are exposed to lead 6. Working atmosphere- Lead concentration in
the working atmosphere should be kept belog
than to any other toxic metal. 2.0 mg per 10cu. metres of air, which is usly
Mode of Absorption - Lead poisoning may the permissible limit or threshold value.
occur in three ways: 7. Periodic examination of workers- All worker
of industrial lead
1. Inhalation- Most cases must be given periodical medical examination
poisoning is due to inhalation of fumes and Laboratory determination of urinary lead.
dust of lead or its compounds. blood lead, red cell count, haemoglobin
by ingestion is of less
2. Ingestion- Poisoning Small estimation and coproporphyrin test of urine
quantities of lead should be done periodically.
common occurrence.
trapped in the upper respiratory tract may be
in food 8. Personal hygiene- Hand washing before eating
ingested. Lead may also be ingested
hands. is an important measure of personal hygiene
or drink through contaminated 9. Health Education- Workers should be
3. Skin- Absorption through skin occurs only in educated on the risks involved and personal
of lead,
respect of the organic compounds Inorganic protection measures.
especially tetraethyl lead. the skin.
compounds are not absorbed through Occupational Cancer
Clinical Picture- The clinical picture of lead
poisoning or plumbism is different in the
inorganic Occupational cancer is a serious problem in
and organic lead exposures. The toxic effects of Industry. The sites of the body most commonly
inorganic lead exposure are abdominal colic. affected are skin, lungs, bladder, and blood-forming
blue-line
obstinate constipation, loss of appetite, organs.
cells, anaemia, wrist to draw
on the gurms, stippling of red
organic Skin cancer- Percival Pott was first
drop and foot drop. The toxic central nervous attention to cancer of scrotum in chimney sweeps
effects of
lead compounds are mostly on mentalthe was subsequently found that cancer of
confusion, in 1775. It
system insomnia, headache, the scrotum and of the skin in other parts of the
delirium, etc.
laboratory body was caused by coal tar. X-rays, certain oils
Diagnosis- History, clinical features, and dyes. Statistics now show that nearly 75 per
Amino levulinie Skin
test (corroprphyrin in urine test, cent of occupational cancers are skin cancer.
acid in urine, lead in blood and urine, basophilic cancers are an occupational hazard amonS goil
distillers,
stipling of RBC test). workers, coke oven workers. tar
in
Prevention and control refiners, dye-stuff makers, road makers and
associated with the use of mineral oil,
1. Substitution - Where possible lead compounds industries
should be substituted by less toxic materials.pitch, tar and related compounds. hazard in gas
2. Isolation- All processes which give rise to Lung cancer- Lung cancer is a
harmful concentration of lead dust or fumes industry, asbestos industry, nickel and chromiu
mining of
should be enclosed and segregated. work, arsenic roasting plants and in the
radio-active substances (e.g. uranium).
3. Local exhaust ventilation- There should be tar
adequate local exhaust ventilation system to Nickel, chromates, asbestos, coal
remove fumes and dust promptly. (presumably 3-4 benzpyrene), radio-active
are pro
4. Personal protection - Workers should be substances and cigarette-smoking beryllium and
protected by approved respirators. carcinogens for the lungs. Arsenic,
5. Good house-keeping- Essential where lead isopropyl oil are suspected carcinogens, Mor
 Occupational Health 559
nineteenthssof lung gcancer are attributed to tobacco
i. Protective devises like masks, shields, aprons
noking, air pollution and occupational exposure. etc to prevent damage
Cancer bladder- It was first noted in man in
aniline industry in 1895. In more recent years, it j Environment monitoring, toxic substances
was noted in the rubberrindustry. It is now known
should be below maximum permissible limits
t cancer bladder is caused by aromatic amines, k. Research- Longitudinal studies should be
conducted about the health of the workers.
which are metabolizedl in the body and excreted in 3.
the urinc. The industries associated with cancer Legislation andActs
adder are the dye-stuffs and dyeing industry. Society has an obligation to protect the health
of the
nubber. gas and the electric cable industries. worker engaged in diverse occupations.
has grown out of the realisation that the worker is
Leukaemia- Exposure to benzol, roentgen rays more important than the machine which ne
and radio-active substances give rise to leukaemia. operates. The worker cannot be permitted to
Benzol is a dangerous chemical and is used as a endanger his life and limb in an occupation, while
solvent in many industries. Leukaemia may appear the employer makes a fortune. Factory laws.
long after exposure has ceased. therefore, have been framed in every country to
Personal hygiene is very important in the govern the conditions in industry and to safeguard
prevention of occupational cancer. the health and welfare of the worker.
Prevention of occupational hazards Factories Act, 1948 and Employees State
Insurance Act, 1948
It can be prevented by 3 levels: Medical,
Engineering and legislation Factories act 1948Factories act 1948-It dates
1. Medical level back to 1881 with latest amendment 1987
1. Scope
a Prior placement examination
a. 10 or more workers are working in a place
b. Periodical check ups or examination where power is used is called as factory
c. Medical and health-care facilities
d. Notification and record maintenance
b. 20 or more workers are working in a place
where no power is used called as factory.
e. Supervision of work environment and There is no difference between perennial
protective measures factory and seasonal factory
1. Health education and counselling 2. Health, safety and welfare
2. Engineering level a. Here cleanliness, lighting, ventilation are
considered
a. Design of building
b. Hygienic measures or good house keeping b. Safety officer is appointed for every 1000 or
more worker
c. General ventilation, exhaust ventilation
d. Mechanization to prevent contact with harmful c Canteen should be present where 250 workers
chemicals are working
e. Substitution for manufacture of less harmful 3. Children below 14 years are prohibited
substance Adolescents: 15-18 years can work after
f. Dust control by water spraying. hydro-blasting surgeon certifics and he cannot do dangerous
works
etc
g. Enclosure by shielding with protective 4. Work lhours
coverage's " Man-48hrs/week
h. Isolation of some risky operations Man-9hrs/day
 Swasthavritta evam Yoga
S60
Finance
"Rest of I2 hrs after Shrs work The different sources of finance to run the
.Adolescent- 41/2 -5 hr/day scheme are:
5. Leave with wages L. Contribution by the employees-1.75 percent
Adult- 1day for 20 days of work, 30days of their wages
(maximum)
40days 2. Contribution by the employers 4.75percent
.Children- 1day for 15days of work, the wages of their workers
(maximum)
should be notified 3. State Government-contributes 1/8 total cost
6. Occupational disease considered
of medical care
7. Employment hazard should be 4. ESI-Corporation-contributes 78 of total cost
Act 1948 of medical care
The Employees State Insurance 5. Government of India--contributes 23 of
amended in administrative expenditure. (Employees getting
ESI Act was passed in 1949 and measure
1975, 1984 and 1989, This is an important daily wages of below I5/- are exempted from
of social security and health
insurance in India. The payment of contribution).
to the
Act provides benefits in Cash and Kind, maternity Benefits to Employees
industrial workers, in case of sickness, 1. Sickness benefit
and employment injury. thereby removing the
economic fear and physical fear. 2. Matermity benefit
3. Disablement benefit
Scope- The ESI Act extends to whole of India.
It applies to all factories (establishments) 4. Dependent benefit
employing less than 20 members and power is 5. Funeral benefit
being used or more than 20 members and power is 6. Medical benefit
not used. The amendment made in 1975, includes 7. Rehabilitation benefit.
the following establishments also Hotels and All these benefits are provided to only those
restaurants, Cinemas and theatres, Road transport
establishments. Newspaper establishments and employees whose wages do not exceed 7500
per month.
Shops.
The administration of ESI Scheme under the Common Services
Act is entrusted to an autonomous body, called 'ESI 1. It includes facilities like OPD services, drug
Corporation", which meets at least twice a year. supply, immunization etc. with the help of
The body consists of the following members Direct and Indirect pattern services
1. Chairman: The Union Minister of Labor.
2. Sickness benefit in the form of cash payment
2. Vice-chairnan: Secretary to Government of for 91 days or even more in sickness condition
India Ministry of Labor. like TB, leprosy, AIDS etc.
3. Five representatives of Central Government. 3. Maternity benefit in the form of cash in case
4. One representative from each State of pregnancy and abortion is provided
Government.
5. One representative for all Union Territories. 4. In case of injury or disability payment is givea
periodically
6. Five representatives of employees.
7. Five representatives of 5. In case of death funeral expenses are borne by
8. Two representatives from
employers. the agency
medical profession. 6. On payment of Rs 10/month the member and
9. Three members of
parliament. his family get free treatment, even afte
retirement or disability.
 Occupational Health 561

Role of Ayurveda in Various Shilajita, Guggulu, Gomutra, Triphala etc and

Occupational Health Problems regular exercise and Lakhaniya Basti
Arsha (piles)- regular sitting on hard surface
challenges but itlakrashitha, Abhyarishta, Ghee, fibre rich food.
Every occupation has its own
everyone to quit the occupation. Anidra (insomnia)- excessive workload
is not possible forshould do his or her occupation Pranayama, Shirodhara, Ashwagandha like
Therefore, one
preventive measures for minimizing the medicine. working
following
times, there were different Shushka Akshi (dry eye syndrome)- exercise,
challenges. In ancient disorders were also too much on the computer- Tarpana, Eye
occupations and occupational Rasayana, Chakshushya medicine.
present time, due gases
different. But in
many Shwasa Roga (asthma)- dust and otherKandha,
technology Haridra
to development of been emerged causing Nasya Karma, Rasayana Dravya,
occupational disorders have disorders. Nowadays. Haritaki Kandha
Karshya ete.
(emaciation)- Ashwagandha,
different occupational personnels, Bruhmaniya Dravya.
farmers, businessmen, defenceown occupational Vidarikanda, Satavari and
labours, etc. have their Shipping / Medical
management is always better The Merchant
disorders. Preventive
management. Ayurveda also Examination Rules 2000
than curative management. Therefore, (Medical Examination)
emphasizes on preventive disorders than The Merchant
Shipping Notification No.
prevent occupational Published vide
2686,
measures Rules, 2000 January, 2000 Act
it is better to There are many preventive who 57(E), dated 19th (Department of
to treat them.occupational disorders. Person rest G.S.R. of Surface Transport
for different physical work should take who does
Ministry
Anofficial
does excess take proper diet. Person exercise Shipping). Examiner.-
properly and physical Approval ofMedical
General of Shipping duly
mental
do
work should both physical and of the Directorate General shallapprove
excess beneficial for authorised
Director suchports
by the Medical Examinersatpurpose
daily. Yoga is of
mental working persons. industries. numbers of necessary for the
problem in manyproducing less Such
places,as deemed 98 of the
Act.
the main used or (2) of
section
seafarer, for the
Dust is
technologyshouldbe high quality sub-section Every
Advanceemployees should be given of working Medical
examination-
and 1 ll oftheAct, shall
and dust.
Temperaturetechnology
of sections98(2) medical examinations,
dust purposes
mask to prevent
maintained by usingDinacharya, subject to the following
namely:
of should be Rulesof be applicable, This medical
place cold areas. Vega, Ahara as may be examination- person
in very hot and
Adharniya andDharniya prevent the Pre-seamedicalconducted before a
(a)examination is includes
Ritucharya, should be followed to seafaringcarcerand
standards of
vihara, etc. cmbarksupon a as per the Annexure-Iand
disordersand Test
diseases. Pre-sea Eye specifiedin specifiedin
occupational physicalfitness Sight standards
Some ofthe
management by Ayurvedasedentary lifestyle standardsofEye medical
(DM) - causeand walking.excessive Annexure-II. examinations-This
periodicintervals
PramehaKashayaRasa Cause Periodicmedical
conducted at
Tikta, foot)- Lepana with (b) examinationis
as perthestandards
Katu, in
(cracks Swedana, seafarer'scareer
Padadari
Abhyanga, duringthe
walking- oilor ghee. physical work
Inck of
 Swasthavritta evam Yoga
562
entisfed individuals after Sth examination.
specified in Annexure-I and Annexure-I. (a)in case of pre-sea medical examination, as
(c) Periodic Eye Test. This Eye Test is conducted specificd in Annexure - IV and Annexure y.
on seafarers appearing for Nautical Grade (b) in case of periodlic medical examination, as
Examinations for issue of Certificate of specified in Annexure-IV; and.
Competency as per the standards specified in (c) in case of periodic Eye test, as specified in
Annexure-) Annexure-V.
Arrangenments for medical examination 2. Medical examiner issues certificate indicatin
applicants for temporary or permanent unfitness if a person
1. The director or officer selects their details,
pre-sca training and registers Continuous fails physical fitness standards.
including full name, age, category. Records of results- Director of pre-sea training
Discharge Certificate. and passport number.
inforn the institute must record medical examination resulte
They schedule the examination and for referred seaman.
medical examiner and applicant. Validity of certificate of physical Fitnes.
provide details
2 The ship owner or agent must name, age,
of a seaman, including full I. Medical certificate validity for seafarers is two
certificate number, passport number, and years unless specificd, except for those under
identification, to a medical examiner and 18 years old, where it is one year.
schedule a medical examination in accordance 2. Ifa medical certificate cxpires during voyage,
with these rules. it remains valid for three months or until an
Appearance for medical examination approved Medical Examiner is available,
Master or scaman must present registration book allowing seafarers to obtain a renewed
and continuous discharge certificate at medical certificate.
examiner's appointed time and place for Appointment of the Appellate Authority
examination and subsequent dates.
Conduct of medical examination 1. Central Government can form Appellate
Authority with three Medical Science
1. Individuals attending medical examinations specialists.
must report to examiners and undergo 2. The Central Government will draw the panel
mínimum tests to determine fitness according
to Annexure-1, II, and IlI standards. of specialists for the appellate authority.
2. Seafarers may nced vaccinations, if applicable. involving representatives of shipowners and
3. Shipping company covers medical seafarers, without empanelled individuals.
Appeal against the decision of the medical
examinations, vaccinations for employmentexaminer- A person
purposes. undergoing medical
Records of medical examinatio examination may appeal against medical examiner
decisions within 60 days, provided they have
1. Medical Examiner records examinations and sufficient cause for not
making the appeal. The
physical fitness certificates for specifiedappeal must be accompanied
periods. by a copy of the
2.
contested order. The Director of
Seamen's
Electronic records must be maintained. Employment Office must refer the appeal to the
3. Records accessible for inspection and Appellate Authority and inform the
verification seaman of the
by surveyors and Directorate examination date and time. The appellate
General. authonty
must give a reasonable opportunity to be heard
Certificate of physical fitness. before disposing of the appeal. The decisions
1. Medical binding on the seaman and ship ownerlagent. A
certificate issucd for physical scaman with