General Methods of Prevention of

Occupational Diseasesfor Medical Undergraduates

Physician - Epidemiologist / Khaled M. AlmazAssistant lecturer, Community Medicine Department,

Aswan University hospital, Aswan, EgyptMaster Degree in Public Health , October 2011Master Degree in Internal Medicine , April 2015

Occupational Health

Promotion & Maintenance of complete physical , mental , social well being of worker in all occupation.

Public Health The science & art of

promoting, preventing disease, prolong life & improving quality of life through the organized efforts of society.

Prevention & Control

Prevention and Control ,, Non-Communicable Syndrome so no General Primary Prevention & Specific Primary Prevention as Infectious ( =

Communicable ) diseases( Infectious Causes as Parasite , Bacteria , Virus )

Primordial : Prevention of Risk Factors.Primary : Health Education – Healthy Diet – Physical Exercise.Secondary : Early Diagnosis and detection by Screening – Treatment.

** control by : case finding by measurements as examination , treatment , follow up.Tertiary : TTT of Complications – Rehabilitation.Complications are 3 : Illness – Disability – Handicapped.

Prevention & Control( Non – Communicable )

Primordial : Prevention of Risk Factors.Primary : Health Education – Healthy Diet – Physical Exercise.Secondary : Screening ( Human Body Weight Measure as a routine) –

Treatment.** control by : case finding by measurements as examination , treatment , follow up.Tertiary : TTT of Complications – Rehabilitation.Complications are 3 : Illness – Disability – Handicapped.

Prevention of Occupational Asthma

( Non – Communicable )1. Transition to safer Chemicals.2. Animal Allergens in the work place should

be removed.3. Control of Dust from Powder Dye Handling

operations.4. Allergic diseases should be controlled.

Prevention of Pneumoconio

sis

Prevention of Pneumoconiosis1. Dust control ( Communicable & Non-

Communicable Prevention ).

2. Segregation of Dusty process.3. Personal protections.4. Health appraisal.

Prevention of PneumoconiosisEngineering Measures

& Environmental Measures Dust control

( Communicable & Non-Communicable Prevention ):

Spraying of ripening cotton : with bactericidal & fungicidal agents

Treatment of raw Cotton fibers : with gaseous hydrogen chloride or acetic acid to inactivate active ingredients in cotton dust.

Personal Protective Equipment : Eye goggles, gloves, safety shoes, face shield, ear muffs & plugs & mask.

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PREVENTION OF OCCUPATIONAL DISEASES

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Health Appraisal Environmental Measures

Pre-Employment Examination Substitution

Periodic Medical Examination Isolation

Personal Protective devices Segregation

Health Education Ventilation

Environmental Monitoring

Assurance of Ergonomics in work place

MEASURES FOR HEALTH PROTECTION OF WORKERS

1. Nutrition.2. Communicable disease control.3. Pre –placement examination.4. Periodical health check up.5. Medical and health care facilities.

1. Water supply 2. Food3. Toilet4. Proper garbage & waste disposal.5. General plant cleanliness.6. Sufficient space.7. Lighting.8. Ventilation.9. Protection against hazards. 10.Notification11.Maintenance & Analysis of Records.12.Health education & counseling.

6 . Environmental SanitationSupervision of Work Environment

7. Mental health: GOALS: To promote health and happiness of workers.

To detect signs of stress and strain and take necessary measures.

Treatment of employees suffering from mental illnesses. Rehabilitation of those who become ill.

8. Measures for women and children.9. Family planning services10. Health education.

MEASURES FOR HEALTH PROTECTION OF WORKERS

Components of an Exposure

History

Part 1

Exposure Survey

Current and past exposure to metals, dust, fibers, fumes, chemicals, biologic hazards, radiation, noise, and/or vibration

Typical workday (job tasks, location, materials, and agents used)

Changes in routines or processesOther employees or household members similarly affected

A. Exposures

1. Chronic Bronchitis ( itis : 5 criteria of Inflammation )

2.  Emphysema ( Barrel Shape Chest in CXR )3.  Refractory Bronchial Asthma ( severe /

non-resolving )4.  Bronchiectasis ( Honeycomb Shape in

Radiology as in CXR , CT )

Types of COPD

VentilationMedical and industrial hygiene surveillance

Employment examsPersonal protective equipment (e.g., respirators, gloves, and coveralls)

Lockout devices, alarms, training, and drills

Personal habits ((Smoke and/or eat in work area? Wash hands with solvents?)

B. Health & Safety Practices at Work Site

1. Physician ( Medical School ; Faculty of Medicine , Medical Collage )..

2. Nurses3. Sanitarians4. Safety supervisor5. Social workers

Health Team Component

Duties of Physician

Preventive servicesClinical Curative services

Preventive services Regular supervision & inspection of work environment Health Education Prevention of and control of communicable infectious

disease Specific 1ry Preventive protection of worker by :

immunization and chemoprophylaxis ( = antimicrobial – antibiotics )

Early case-finding, notification to local health office and management

Control measure for work contact

Clinical Curative services Health appraisal : screening tests Clinical service: diagnosis & ttt of disease in out patient

clinic of factory, giving sick leaves or referral of cases Supervision of health record for registration and preparation

of reports First aid measure and emergency services

Part 2

Work History

A. Description of all previous Jobs including :-

1. Short-term, 2. Seasonal, 3. Part-time 4. Employment ,5. Military serviceB. Description of present Jobs

Part 3

Environmental History

1. Present & previous home locations2. Jobs of household members3. Home insulating & heating & cooling system4. Home cleaning agents5. Pesticide exposure6. Water supply7. Recent renovation/remodeling ( ( – تحديث تجديد8. Air pollution ( Indoor & Outdoor )9. Hobbies ( painting, photography, sculpting النحت, welding

,woodworking, piloting, restoring automobiles ,لحامshooting firearms, creating stained glass الملون الزجاج ,خلقcreating ceramics, gardening البساتين و …( التشجير

10. Hazardous wastes/spill exposure / التعرض الخطرة النفايات تسرب

Insulation acts as a barrier to heat flow and is essential for keeping your home warm in winter & cool in summer.

A well-insulated and well-designed home provides year-round comfort, cutting cooling and heating bills by up to half. This, in turn, reduces greenhouse gas emissions.

Climatic conditions influence the appropriate level and type of insulation. Establish whether the insulation is predominantly needed to keep heat out or in (or both). Insulation must cater for seasonal as well as daily variations in temperature

Insulation ( definition )

Ergonomics Program

Fitting the Job to the Worker.

Adjustment of Man & Machine.

Integral part of occupational health services.

Ergo-friendly tools: Tools which reduce the stresses or problems resulting work

Greek word ‘Ergon’ means ‘Work’,

‘Nomos’ means ‘Law’ .

It is the 1. ADAPTATION, 2. MODIFICATION, 3. MANIPULATION of 4. MACHINERY WORK ,5. ENVIRONMENT WORK , 6. REST SCHEDULE , 7. JOB DEMANDS to suit the 8. CAPACITY, 9. LIMITATIONS & 10.EXPECTATIONS of the workers

, , , , استشراف, مشهد منظر مستقبل آفاق .توقعات

The study of work in relation to the environment in which it is performed (the workplace) and those who perform it (workers).

Aim to optimize comfort as well as safety, health and efficiency to workers

Examples:1. Prevention of Accidents2. Prevention of Fatigue3. Prevention of Musculo-Skeletal Disorders

Ergonomics

Ergonomic disorders

1. Decrease injuries, illness & work compensation cost.

2. Increase efficiency at work

3. Increases physical well being

4. Decrease absenteeism ( not go to work ) & turn over5. Increases in employee morale.

Benefits of an Ergonomic program

Preventive program

of

Industrial Health

1 - Medical

Measures

1. Medical measures1. Pre-Placement Examination

CXR , Atopy ( Allergy disease as Asthma )

2. Periodic Medical Examination Conducted every year If susceptible worker (significant effect across shift

after few month of exposure) should be transferred to other job

3. Health record

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4 - 1st Emergency aid.

5 - Principles of public health are applied to workers in industry as :-

immunization, nutrition program ( Food Control ) , Health Education & Health

Counselling , mental health, dental care , housing.

Rehabilitation: This may be done at place of work.

This should include not only invalid from accidents but also disabled from

diseases.

6 - Diagnosis & treatment of occupational diseases.

1. Medical measures

7 - Health Education8 - Health Promotion

Components of Health Promotion:

1. Adequate nutrition.

2. Sanitary environment.

3. Prevention of fatigue.

4. Social activities.

5. Living standard

1. Medical measures

Elimination of hazardous materials. Substitution of hazardous material by a harmless one or one of lesser toxicity.

Isolation the harmful materials and process will prevent the escape of dust & fumes – دخان بخارinto the factory atmosphere.

Prevention of Industrial hazards

2 – Engineering Measures

Engineering Control:1. - Dangerous part of machine securely guarded.2. - Good maintenance of machine.3. - Automatic feeding of machine.4. - Mechanization of process.

5. - Ergonomics

Engineering Measures

& 3 –

Environmental Measures

Engineering Measures & Environmental Measures

1. Dust control:Spraying of ripening cotton : with bactericidal &

fungicidal agentsTreatment of raw Cotton fibers : with gaseous hydrogen

chloride or acetic acid to inactivate active ingredients in cotton dust

Personal Protective Equipment : Eye goggles, gloves, safety shoes, face shield, ear muffs & plugs & mask.

2. Segregation of Dusty process.3. Personal protections.

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3 – Environmental

Measures

1. Good ventilation ( for heat & gases)

2. Lightening

3. Water supply

4. Sanitary processes e.g. toilets

5. Waste disposal

6. Insect control ( Insecticides or other Methods )

7. Food control ( according to Job Place , Job Description , age , sex )

8. Zoning التقسيم - مناطق مقسمة ( zone >>> zone part 1 + zone part 2 … etc ).

Industrial Hygiene ( Working Environment )

Other Measures

Administrative Control

Administrative Control

Provide & care for safety, limiting extended Work hours & providing breaks including Food Control …

Safety organization

Safety organization

aim to cooperate all persons employed to keep safety & deal with

accidents e.g.:

1 - accident prevention committees ( Health Team Component ) , 2 - Safety incentivesحوافز و مكافات , 3 - warning ( alarm ) notices

4 - posters.

Training for Safety Methods.

Industrial legislationStatistical studiesResearches: Research in occupational health affords fertility ground for study which can provide a better understanding of the industrial health problems.

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